National Provider Identifier [NPI]: |
1104925106 |
Last Name Of The Provider |
SYLVAIN |
First Name Of The Provider |
GAYLA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1325 ROCK QUARRY RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
STOCKBRIDGE |
Zip Code Of The Provider |
302815088 |
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 |
56 |
Number Of Services |
2218 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
243307.5 |
Total Medicare Allowed Amount |
117811.87 |
Total Medicare Payment Amount |
88028.78 |
Total Medicare Standardized Payment Amount |
78824.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
116 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
2690 |
Total Drug Medicare AllowedAmount |
481.76 |
Total Drug Medicare PaymentAmount |
419.88 |
Total Drug Medicare Standardized Payment Amount |
419.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
2102 |
Number Of Medicare Beneficiaries With Medical Services |
173 |
Total Medical Submitted Charge Amount |
240617.5 |
Total Medical Medicare Allowed Amount |
117330.11 |
Total Medical Medicare Payment Amount |
87608.9 |
Total Medical Medicare Standardized Payment Amount |
78404.77 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
97 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8068 |