National Provider Identifier [NPI]: |
1073552550 |
Last Name Of The Provider |
COLQUITT |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
906 JUDSON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LONGVIEW |
Zip Code Of The Provider |
756015113 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
285 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
302567 |
Total Medicare Allowed Amount |
63930.6 |
Total Medicare Payment Amount |
48629.49 |
Total Medicare Standardized Payment Amount |
51383.05 |
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 |
65 |
Number Of Medical Services |
285 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
302567 |
Total Medical Medicare Allowed Amount |
63930.6 |
Total Medical Medicare Payment Amount |
48629.49 |
Total Medical Medicare Standardized Payment Amount |
51383.05 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
181 |
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 |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.2291 |