National Provider Identifier [NPI]: |
1760544241 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2160 EWING CRAWFIS CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLEFONTAINE |
Zip Code Of The Provider |
433119042 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
423 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
162613.9 |
Total Medicare Allowed Amount |
84682.21 |
Total Medicare Payment Amount |
65918.7 |
Total Medicare Standardized Payment Amount |
66389.08 |
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 |
86 |
Number Of Medical Services |
423 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
162613.9 |
Total Medical Medicare Allowed Amount |
84682.21 |
Total Medical Medicare Payment Amount |
65918.7 |
Total Medical Medicare Standardized Payment Amount |
66389.08 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2079 |