National Provider Identifier [NPI]: |
1184784845 |
Last Name Of The Provider |
SUTHERLAND |
First Name Of The Provider |
DEON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 SW 1ST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344716504 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
582 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
127090 |
Total Medicare Allowed Amount |
64758.19 |
Total Medicare Payment Amount |
49952.2 |
Total Medicare Standardized Payment Amount |
49590.49 |
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 |
18 |
Number Of Medical Services |
582 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
127090 |
Total Medical Medicare Allowed Amount |
64758.19 |
Total Medical Medicare Payment Amount |
49952.2 |
Total Medical Medicare Standardized Payment Amount |
49590.49 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
138 |
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 |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
61 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.6911 |