National Provider Identifier [NPI]: |
1780626804 |
Last Name Of The Provider |
LOGAN |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4700 WATERS AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314046220 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
3997 |
Number Of Medicare Beneficiaries |
680 |
Total Submitted Charge Amount |
286360 |
Total Medicare Allowed Amount |
109523.98 |
Total Medicare Payment Amount |
77992.55 |
Total Medicare Standardized Payment Amount |
83714.49 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
282 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
412 |
Number Of Male Beneficiaries |
268 |
Number Of Non Hispanic White Beneficiaries |
581 |
Number Of Black or African American Beneficiaries |
82 |
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 |
623 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0834 |