National Provider Identifier [NPI]: |
1780665174 |
Last Name Of The Provider |
MAHAN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
250 E LIBERTY ST |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402021530 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
861 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
475392.87 |
Total Medicare Allowed Amount |
180477.84 |
Total Medicare Payment Amount |
139457.14 |
Total Medicare Standardized Payment Amount |
147250.74 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
218 |
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4172 |