National Provider Identifier [NPI]: |
1659327484 |
Last Name Of The Provider |
HAWK |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
105 COLLIER RD NW |
Street Address 2 Of The Provider |
SUITE 5020 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303091710 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
1063 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
126300 |
Total Medicare Allowed Amount |
53681.03 |
Total Medicare Payment Amount |
40067.46 |
Total Medicare Standardized Payment Amount |
40200.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
130 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
7801 |
Total Drug Medicare AllowedAmount |
2543.09 |
Total Drug Medicare PaymentAmount |
2322.35 |
Total Drug Medicare Standardized Payment Amount |
2322.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
933 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
118499 |
Total Medical Medicare Allowed Amount |
51137.94 |
Total Medical Medicare Payment Amount |
37745.11 |
Total Medical Medicare Standardized Payment Amount |
37878.03 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
178 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7701 |