National Provider Identifier [NPI]: |
1356550610 |
Last Name Of The Provider |
JOSEPH |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3025 SHRINE RD |
Street Address 2 Of The Provider |
SUITE 190 |
City Of The Provider |
BRUNSWICK |
Zip Code Of The Provider |
315204784 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
118 |
Number Of Medicare Beneficiaries |
41 |
Total Submitted Charge Amount |
47972.2 |
Total Medicare Allowed Amount |
14095.79 |
Total Medicare Payment Amount |
10990.96 |
Total Medicare Standardized Payment Amount |
11571.67 |
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 |
39 |
Number Of Medical Services |
118 |
Number Of Medicare Beneficiaries With Medical Services |
41 |
Total Medical Submitted Charge Amount |
47972.2 |
Total Medical Medicare Allowed Amount |
14095.79 |
Total Medical Medicare Payment Amount |
10990.96 |
Total Medical Medicare Standardized Payment Amount |
11571.67 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
41 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
27 |
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 |
18 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
41 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1377 |