National Provider Identifier [NPI]: |
1902957582 |
Last Name Of The Provider |
CHAVERS |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1369 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DOTHAN |
Zip Code Of The Provider |
363011309 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
3131 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
310271.44 |
Total Medicare Allowed Amount |
295762.56 |
Total Medicare Payment Amount |
220070.63 |
Total Medicare Standardized Payment Amount |
226652.91 |
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 |
15 |
Number Of Medical Services |
3131 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
310271.44 |
Total Medical Medicare Allowed Amount |
295762.56 |
Total Medical Medicare Payment Amount |
220070.63 |
Total Medical Medicare Standardized Payment Amount |
226652.91 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
291 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
246 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
59 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
34 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.1458 |