National Provider Identifier [NPI]: |
1225262397 |
Last Name Of The Provider |
DAVIS-SINGLETARY |
First Name Of The Provider |
LESLIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 PRUDENTIAL DR STE 304 |
Street Address 2 Of The Provider |
CREDENTIALING DEPARTMENT |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322078205 |
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 |
15 |
Number Of Services |
1302 |
Number Of Medicare Beneficiaries |
508 |
Total Submitted Charge Amount |
233076 |
Total Medicare Allowed Amount |
137191.38 |
Total Medicare Payment Amount |
106604.35 |
Total Medicare Standardized Payment Amount |
106603.7 |
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 |
1302 |
Number Of Medicare Beneficiaries With Medical Services |
508 |
Total Medical Submitted Charge Amount |
233076 |
Total Medical Medicare Allowed Amount |
137191.38 |
Total Medical Medicare Payment Amount |
106604.35 |
Total Medical Medicare Standardized Payment Amount |
106603.7 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
292 |
Number Of Male Beneficiaries |
216 |
Number Of Non Hispanic White Beneficiaries |
373 |
Number Of Black or African American Beneficiaries |
109 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.6228 |