National Provider Identifier [NPI]: |
1922271535 |
Last Name Of The Provider |
HAWKINS |
First Name Of The Provider |
BERT |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 AUDUBON PLAZA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402171318 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
2072 |
Number Of Medicare Beneficiaries |
1108 |
Total Submitted Charge Amount |
767076 |
Total Medicare Allowed Amount |
165937.13 |
Total Medicare Payment Amount |
128793.45 |
Total Medicare Standardized Payment Amount |
133982.8 |
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 |
39 |
Number Of Medical Services |
2072 |
Number Of Medicare Beneficiaries With Medical Services |
1108 |
Total Medical Submitted Charge Amount |
767076 |
Total Medical Medicare Allowed Amount |
165937.13 |
Total Medical Medicare Payment Amount |
128793.45 |
Total Medical Medicare Standardized Payment Amount |
133982.8 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
363 |
Number Of Beneficiaries Age 65 to 74 |
293 |
Number Of Beneficiaries Age 75 to 84 |
272 |
Number Of Beneficiaries Age Greater 84 |
180 |
Number Of Female Beneficiaries |
670 |
Number Of Male Beneficiaries |
438 |
Number Of Non Hispanic White Beneficiaries |
877 |
Number Of Black or African American Beneficiaries |
215 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
680 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
428 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1683 |