National Provider Identifier [NPI]: |
1235106790 |
Last Name Of The Provider |
LYNDE |
First Name Of The Provider |
GRANT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD, MBA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 DOWMAN DR NE |
Street Address 2 Of The Provider |
EMORY DEPARTMENT OF ANESTHESIOLOGY |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303221007 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
111 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
126422 |
Total Medicare Allowed Amount |
20703.72 |
Total Medicare Payment Amount |
16231.65 |
Total Medicare Standardized Payment Amount |
16264.47 |
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 |
48 |
Number Of Medical Services |
111 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
126422 |
Total Medical Medicare Allowed Amount |
20703.72 |
Total Medical Medicare Payment Amount |
16231.65 |
Total Medical Medicare Standardized Payment Amount |
16264.47 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
85 |
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 |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.983 |