National Provider Identifier [NPI]: |
1558411249 |
Last Name Of The Provider |
BAISDEN |
First Name Of The Provider |
BLAIRE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4700 WATERS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314046220 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2689 |
Number Of Medicare Beneficiaries |
938 |
Total Submitted Charge Amount |
314101 |
Total Medicare Allowed Amount |
106122.2 |
Total Medicare Payment Amount |
81891.92 |
Total Medicare Standardized Payment Amount |
65246.71 |
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 |
35 |
Number Of Medical Services |
2689 |
Number Of Medicare Beneficiaries With Medical Services |
938 |
Total Medical Submitted Charge Amount |
314101 |
Total Medical Medicare Allowed Amount |
106122.2 |
Total Medical Medicare Payment Amount |
81891.92 |
Total Medical Medicare Standardized Payment Amount |
65246.71 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
178 |
Number Of Beneficiaries Age 65 to 74 |
414 |
Number Of Beneficiaries Age 75 to 84 |
251 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
554 |
Number Of Male Beneficiaries |
384 |
Number Of Non Hispanic White Beneficiaries |
714 |
Number Of Black or African American Beneficiaries |
193 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
722 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
216 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5563 |