National Provider Identifier [NPI]: |
1457343196 |
Last Name Of The Provider |
HUDDLESTON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1351 E MCPHERSON HWY |
Street Address 2 Of The Provider |
SUITE 150 |
City Of The Provider |
CLYDE |
Zip Code Of The Provider |
434109765 |
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 |
140 |
Number Of Services |
4343 |
Number Of Medicare Beneficiaries |
385 |
Total Submitted Charge Amount |
602455 |
Total Medicare Allowed Amount |
247005.82 |
Total Medicare Payment Amount |
186390.46 |
Total Medicare Standardized Payment Amount |
190284.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
2725 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
89003 |
Total Drug Medicare AllowedAmount |
33697.42 |
Total Drug Medicare PaymentAmount |
26375.86 |
Total Drug Medicare Standardized Payment Amount |
26375.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
134 |
Number Of Medical Services |
1618 |
Number Of Medicare Beneficiaries With Medical Services |
385 |
Total Medical Submitted Charge Amount |
513452 |
Total Medical Medicare Allowed Amount |
213308.4 |
Total Medical Medicare Payment Amount |
160014.6 |
Total Medical Medicare Standardized Payment Amount |
163908.58 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
238 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
365 |
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 |
320 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1561 |