National Provider Identifier [NPI]: |
1982661641 |
Last Name Of The Provider |
TRIPP |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 STARLING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRUNSWICK |
Zip Code Of The Provider |
315204219 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1805 |
Number Of Medicare Beneficiaries |
243 |
Total Submitted Charge Amount |
459195 |
Total Medicare Allowed Amount |
124078.9 |
Total Medicare Payment Amount |
96701.12 |
Total Medicare Standardized Payment Amount |
96216.24 |
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 |
30 |
Number Of Medical Services |
1805 |
Number Of Medicare Beneficiaries With Medical Services |
243 |
Total Medical Submitted Charge Amount |
459195 |
Total Medical Medicare Allowed Amount |
124078.9 |
Total Medical Medicare Payment Amount |
96701.12 |
Total Medical Medicare Standardized Payment Amount |
96216.24 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
213 |
Number Of Black or African American Beneficiaries |
|
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5286 |