National Provider Identifier [NPI]: |
1083629893 |
Last Name Of The Provider |
GROLEMUND |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10 PROFESSIONAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRUNSWICK |
Zip Code Of The Provider |
315203774 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1468 |
Number Of Medicare Beneficiaries |
549 |
Total Submitted Charge Amount |
275835.4 |
Total Medicare Allowed Amount |
102565.13 |
Total Medicare Payment Amount |
73320.66 |
Total Medicare Standardized Payment Amount |
79512.93 |
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 |
34 |
Number Of Medical Services |
1468 |
Number Of Medicare Beneficiaries With Medical Services |
549 |
Total Medical Submitted Charge Amount |
275835.4 |
Total Medical Medicare Allowed Amount |
102565.13 |
Total Medical Medicare Payment Amount |
73320.66 |
Total Medical Medicare Standardized Payment Amount |
79512.93 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
311 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
424 |
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 |
435 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5374 |