National Provider Identifier [NPI]: |
1972741593 |
Last Name Of The Provider |
GANDY |
First Name Of The Provider |
AUBREY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4370 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DOTHAN |
Zip Code Of The Provider |
363051056 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
2335 |
Number Of Medicare Beneficiaries |
865 |
Total Submitted Charge Amount |
289188.66 |
Total Medicare Allowed Amount |
79612.54 |
Total Medicare Payment Amount |
61863.43 |
Total Medicare Standardized Payment Amount |
48202.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
2335 |
Number Of Medicare Beneficiaries With Medical Services |
865 |
Total Medical Submitted Charge Amount |
289188.66 |
Total Medical Medicare Allowed Amount |
79612.54 |
Total Medical Medicare Payment Amount |
61863.43 |
Total Medical Medicare Standardized Payment Amount |
48202.69 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
355 |
Number Of Beneficiaries Age 75 to 84 |
278 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
487 |
Number Of Male Beneficiaries |
378 |
Number Of Non Hispanic White Beneficiaries |
711 |
Number Of Black or African American Beneficiaries |
136 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
654 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
211 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4215 |