National Provider Identifier [NPI]: |
1588659098 |
Last Name Of The Provider |
SWOR |
First Name Of The Provider |
GRAY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3210 FRUITVILLE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SARASOTA |
Zip Code Of The Provider |
342376411 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
15222 |
Number Of Medicare Beneficiaries |
509 |
Total Submitted Charge Amount |
10627308.86 |
Total Medicare Allowed Amount |
2892369.74 |
Total Medicare Payment Amount |
2261503.5 |
Total Medicare Standardized Payment Amount |
2266553.41 |
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 |
49 |
Number Of Medical Services |
15222 |
Number Of Medicare Beneficiaries With Medical Services |
509 |
Total Medical Submitted Charge Amount |
10627308.86 |
Total Medical Medicare Allowed Amount |
2892369.74 |
Total Medical Medicare Payment Amount |
2261503.5 |
Total Medical Medicare Standardized Payment Amount |
2266553.41 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
255 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
487 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
483 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2379 |