National Provider Identifier [NPI]: |
1629005020 |
Last Name Of The Provider |
AVERILL |
First Name Of The Provider |
FRANCIS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
802 N BELCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEARWATER |
Zip Code Of The Provider |
337652103 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
7625 |
Number Of Medicare Beneficiaries |
694 |
Total Submitted Charge Amount |
1078855.98 |
Total Medicare Allowed Amount |
524117.24 |
Total Medicare Payment Amount |
403105.9 |
Total Medicare Standardized Payment Amount |
404424.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
1135 |
Number Of Medicare Beneficiaries With Drug Services |
152 |
Total Drug Submitted ChargeAmount |
9200.41 |
Total Drug Medicare AllowedAmount |
4847.92 |
Total Drug Medicare PaymentAmount |
4527.76 |
Total Drug Medicare Standardized Payment Amount |
4527.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
6490 |
Number Of Medicare Beneficiaries With Medical Services |
693 |
Total Medical Submitted Charge Amount |
1069655.57 |
Total Medical Medicare Allowed Amount |
519269.32 |
Total Medical Medicare Payment Amount |
398578.14 |
Total Medical Medicare Standardized Payment Amount |
399896.44 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
254 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
416 |
Number Of Male Beneficiaries |
278 |
Number Of Non Hispanic White Beneficiaries |
637 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
533 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
57 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9408 |