National Provider Identifier [NPI]: |
1245207448 |
Last Name Of The Provider |
SKELTON |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16063 HIGHWAY 69 S |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOUNDVILLE |
Zip Code Of The Provider |
354746209 |
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 |
71 |
Number Of Services |
5540 |
Number Of Medicare Beneficiaries |
798 |
Total Submitted Charge Amount |
229938.6 |
Total Medicare Allowed Amount |
202874.85 |
Total Medicare Payment Amount |
133134.64 |
Total Medicare Standardized Payment Amount |
158720.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
1208 |
Number Of Medicare Beneficiaries With Drug Services |
308 |
Total Drug Submitted ChargeAmount |
17523 |
Total Drug Medicare AllowedAmount |
4707.33 |
Total Drug Medicare PaymentAmount |
4254.92 |
Total Drug Medicare Standardized Payment Amount |
4254.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
4332 |
Number Of Medicare Beneficiaries With Medical Services |
798 |
Total Medical Submitted Charge Amount |
212415.6 |
Total Medical Medicare Allowed Amount |
198167.52 |
Total Medical Medicare Payment Amount |
128879.72 |
Total Medical Medicare Standardized Payment Amount |
154465.69 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
188 |
Number Of Beneficiaries Age 65 to 74 |
321 |
Number Of Beneficiaries Age 75 to 84 |
215 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
467 |
Number Of Male Beneficiaries |
331 |
Number Of Non Hispanic White Beneficiaries |
706 |
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 |
649 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0156 |