National Provider Identifier [NPI]: |
1093877987 |
Last Name Of The Provider |
LAWRENCE |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 TURNER MCCALL BLVD SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROME |
Zip Code Of The Provider |
301655630 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
1049 |
Number Of Medicare Beneficiaries |
316 |
Total Submitted Charge Amount |
276894 |
Total Medicare Allowed Amount |
103397.04 |
Total Medicare Payment Amount |
81338.53 |
Total Medicare Standardized Payment Amount |
87622.89 |
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 |
64 |
Number Of Medical Services |
1049 |
Number Of Medicare Beneficiaries With Medical Services |
316 |
Total Medical Submitted Charge Amount |
276894 |
Total Medical Medicare Allowed Amount |
103397.04 |
Total Medical Medicare Payment Amount |
81338.53 |
Total Medical Medicare Standardized Payment Amount |
87622.89 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
316 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
285 |
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 |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0385 |