National Provider Identifier [NPI]: |
1437134301 |
Last Name Of The Provider |
MILLS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1005 MAR WALT DR |
Street Address 2 Of The Provider |
IMMEDIATE CARE DEPARTMENT |
City Of The Provider |
FORT WALTON BEACH |
Zip Code Of The Provider |
325476707 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
3504 |
Number Of Medicare Beneficiaries |
674 |
Total Submitted Charge Amount |
297072 |
Total Medicare Allowed Amount |
141835.12 |
Total Medicare Payment Amount |
99967.21 |
Total Medicare Standardized Payment Amount |
102355.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
19 |
Number Of Drug Services |
1745 |
Number Of Medicare Beneficiaries With Drug Services |
362 |
Total Drug Submitted ChargeAmount |
23378 |
Total Drug Medicare AllowedAmount |
2792.79 |
Total Drug Medicare PaymentAmount |
2209.86 |
Total Drug Medicare Standardized Payment Amount |
2209.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
1759 |
Number Of Medicare Beneficiaries With Medical Services |
674 |
Total Medical Submitted Charge Amount |
273694 |
Total Medical Medicare Allowed Amount |
139042.33 |
Total Medical Medicare Payment Amount |
97757.35 |
Total Medical Medicare Standardized Payment Amount |
100145.79 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
275 |
Number Of Beneficiaries Age 75 to 84 |
255 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
402 |
Number Of Male Beneficiaries |
272 |
Number Of Non Hispanic White Beneficiaries |
632 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
637 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1221 |