National Provider Identifier [NPI]: |
1912958265 |
Last Name Of The Provider |
GUY |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
410 W 10TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432101240 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
685 |
Number Of Medicare Beneficiaries |
210 |
Total Submitted Charge Amount |
311082 |
Total Medicare Allowed Amount |
73136.81 |
Total Medicare Payment Amount |
56073.79 |
Total Medicare Standardized Payment Amount |
57823.23 |
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 |
80 |
Number Of Medical Services |
685 |
Number Of Medicare Beneficiaries With Medical Services |
210 |
Total Medical Submitted Charge Amount |
311082 |
Total Medical Medicare Allowed Amount |
73136.81 |
Total Medical Medicare Payment Amount |
56073.79 |
Total Medical Medicare Standardized Payment Amount |
57823.23 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
169 |
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 |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.2066 |