National Provider Identifier [NPI]: |
1922190255 |
Last Name Of The Provider |
MCCLORY |
First Name Of The Provider |
JILL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
225 18TH ST SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HICKORY |
Zip Code Of The Provider |
286021364 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
12951 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
759655 |
Total Medicare Allowed Amount |
423957.71 |
Total Medicare Payment Amount |
310401.16 |
Total Medicare Standardized Payment Amount |
317924.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
11722 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
564587 |
Total Drug Medicare AllowedAmount |
307640.29 |
Total Drug Medicare PaymentAmount |
228969.14 |
Total Drug Medicare Standardized Payment Amount |
228969.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
1229 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
195068 |
Total Medical Medicare Allowed Amount |
116317.42 |
Total Medical Medicare Payment Amount |
81432.02 |
Total Medical Medicare Standardized Payment Amount |
88955.6 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
321 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2111 |