National Provider Identifier [NPI]: |
1083618987 |
Last Name Of The Provider |
PEARSON |
First Name Of The Provider |
CLARENCE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
307 BOATNER RD |
Street Address 2 Of The Provider |
SUITE 114 |
City Of The Provider |
EGLIN AFB |
Zip Code Of The Provider |
325421302 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1901 |
Number Of Medicare Beneficiaries |
1046 |
Total Submitted Charge Amount |
421055 |
Total Medicare Allowed Amount |
134941.62 |
Total Medicare Payment Amount |
99153.13 |
Total Medicare Standardized Payment Amount |
103318.25 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
153 |
Number Of Beneficiaries Age 65 to 74 |
376 |
Number Of Beneficiaries Age 75 to 84 |
357 |
Number Of Beneficiaries Age Greater 84 |
160 |
Number Of Female Beneficiaries |
516 |
Number Of Male Beneficiaries |
530 |
Number Of Non Hispanic White Beneficiaries |
913 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
109 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
661 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
385 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3948 |