National Provider Identifier [NPI]: |
1447361241 |
Last Name Of The Provider |
ANDERSON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 INNOVATION DR |
Street Address 2 Of The Provider |
SUITE 140 |
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
296075261 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
4170.5 |
Number Of Medicare Beneficiaries |
589 |
Total Submitted Charge Amount |
434708 |
Total Medicare Allowed Amount |
234310.98 |
Total Medicare Payment Amount |
166087.45 |
Total Medicare Standardized Payment Amount |
181718.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
395.5 |
Number Of Medicare Beneficiaries With Drug Services |
291 |
Total Drug Submitted ChargeAmount |
15635 |
Total Drug Medicare AllowedAmount |
13201.5 |
Total Drug Medicare PaymentAmount |
12902.33 |
Total Drug Medicare Standardized Payment Amount |
12902.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
3775 |
Number Of Medicare Beneficiaries With Medical Services |
588 |
Total Medical Submitted Charge Amount |
419073 |
Total Medical Medicare Allowed Amount |
221109.48 |
Total Medical Medicare Payment Amount |
153185.12 |
Total Medical Medicare Standardized Payment Amount |
168816.35 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
267 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
339 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
544 |
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 |
568 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9533 |