National Provider Identifier [NPI]: |
1477599389 |
Last Name Of The Provider |
TEMPLETON |
First Name Of The Provider |
GARY |
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 |
3344 N FUTRALL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FAYETTEVILLE |
Zip Code Of The Provider |
727034057 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
5315 |
Number Of Medicare Beneficiaries |
901 |
Total Submitted Charge Amount |
466206 |
Total Medicare Allowed Amount |
257704.54 |
Total Medicare Payment Amount |
193068.61 |
Total Medicare Standardized Payment Amount |
210773.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1961 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
25010 |
Total Drug Medicare AllowedAmount |
20454.76 |
Total Drug Medicare PaymentAmount |
16233.73 |
Total Drug Medicare Standardized Payment Amount |
16233.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
3354 |
Number Of Medicare Beneficiaries With Medical Services |
901 |
Total Medical Submitted Charge Amount |
441196 |
Total Medical Medicare Allowed Amount |
237249.78 |
Total Medical Medicare Payment Amount |
176834.88 |
Total Medical Medicare Standardized Payment Amount |
194539.63 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
151 |
Number Of Beneficiaries Age 65 to 74 |
362 |
Number Of Beneficiaries Age 75 to 84 |
311 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
478 |
Number Of Male Beneficiaries |
423 |
Number Of Non Hispanic White Beneficiaries |
847 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
23 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
706 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
195 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
28 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6531 |