National Provider Identifier [NPI]: |
1619977378 |
Last Name Of The Provider |
HERBERHOLZ |
First Name Of The Provider |
LAWRENCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
911 S BROAD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCOTTSBORO |
Zip Code Of The Provider |
357682509 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
145 |
Number Of Services |
1322 |
Number Of Medicare Beneficiaries |
418 |
Total Submitted Charge Amount |
404323 |
Total Medicare Allowed Amount |
200229.19 |
Total Medicare Payment Amount |
151726.12 |
Total Medicare Standardized Payment Amount |
169786.37 |
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 |
145 |
Number Of Medical Services |
1322 |
Number Of Medicare Beneficiaries With Medical Services |
418 |
Total Medical Submitted Charge Amount |
404323 |
Total Medical Medicare Allowed Amount |
200229.19 |
Total Medical Medicare Payment Amount |
151726.12 |
Total Medical Medicare Standardized Payment Amount |
169786.37 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
400 |
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 |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3194 |