National Provider Identifier [NPI]: |
1770566283 |
Last Name Of The Provider |
MILLARD |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
323 E TOWN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432154753 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
94 |
Number Of Services |
844 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
298535.07 |
Total Medicare Allowed Amount |
104803.05 |
Total Medicare Payment Amount |
78263.29 |
Total Medicare Standardized Payment Amount |
81873.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
134 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
4870 |
Total Drug Medicare AllowedAmount |
3507.04 |
Total Drug Medicare PaymentAmount |
2749.61 |
Total Drug Medicare Standardized Payment Amount |
2749.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
710 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
293665.07 |
Total Medical Medicare Allowed Amount |
101296.01 |
Total Medical Medicare Payment Amount |
75513.68 |
Total Medical Medicare Standardized Payment Amount |
79123.5 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
112 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3987 |