National Provider Identifier [NPI]: |
1780812867 |
Last Name Of The Provider |
MASON |
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 |
1200 RIVERPLACE BLVD |
Street Address 2 Of The Provider |
#620 |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322079046 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2674 |
Number Of Medicare Beneficiaries |
668 |
Total Submitted Charge Amount |
558642 |
Total Medicare Allowed Amount |
282379.32 |
Total Medicare Payment Amount |
220968.6 |
Total Medicare Standardized Payment Amount |
219461.82 |
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 |
18 |
Number Of Medical Services |
2674 |
Number Of Medicare Beneficiaries With Medical Services |
668 |
Total Medical Submitted Charge Amount |
558642 |
Total Medical Medicare Allowed Amount |
282379.32 |
Total Medical Medicare Payment Amount |
220968.6 |
Total Medical Medicare Standardized Payment Amount |
219461.82 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
426 |
Number Of Male Beneficiaries |
242 |
Number Of Non Hispanic White Beneficiaries |
520 |
Number Of Black or African American Beneficiaries |
107 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
472 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.5641 |