National Provider Identifier [NPI]: |
1174743223 |
Last Name Of The Provider |
BEDSOLE |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6701 AIRPORT BLVD |
Street Address 2 Of The Provider |
SUITE B135 |
City Of The Provider |
MOBILE |
Zip Code Of The Provider |
36608 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
5788 |
Number Of Medicare Beneficiaries |
727 |
Total Submitted Charge Amount |
675752 |
Total Medicare Allowed Amount |
402555.03 |
Total Medicare Payment Amount |
302484.1 |
Total Medicare Standardized Payment Amount |
330549.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
582 |
Number Of Medicare Beneficiaries With Drug Services |
56 |
Total Drug Submitted ChargeAmount |
3240 |
Total Drug Medicare AllowedAmount |
526.81 |
Total Drug Medicare PaymentAmount |
495.84 |
Total Drug Medicare Standardized Payment Amount |
495.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
5206 |
Number Of Medicare Beneficiaries With Medical Services |
727 |
Total Medical Submitted Charge Amount |
672512 |
Total Medical Medicare Allowed Amount |
402028.22 |
Total Medical Medicare Payment Amount |
301988.26 |
Total Medical Medicare Standardized Payment Amount |
330053.21 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
132 |
Number Of Beneficiaries Age 65 to 74 |
277 |
Number Of Beneficiaries Age 75 to 84 |
236 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
389 |
Number Of Male Beneficiaries |
338 |
Number Of Non Hispanic White Beneficiaries |
622 |
Number Of Black or African American Beneficiaries |
91 |
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 |
576 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
51 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9681 |