National Provider Identifier [NPI]: |
1821181991 |
Last Name Of The Provider |
JACKSON |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1230 BALD RIDGE MARINA RD |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
CUMMING |
Zip Code Of The Provider |
300417536 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
1076 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
554792.2 |
Total Medicare Allowed Amount |
100323.1 |
Total Medicare Payment Amount |
70554.45 |
Total Medicare Standardized Payment Amount |
71527.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
138 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
25290 |
Total Drug Medicare AllowedAmount |
6140.54 |
Total Drug Medicare PaymentAmount |
4526.65 |
Total Drug Medicare Standardized Payment Amount |
4526.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
938 |
Number Of Medicare Beneficiaries With Medical Services |
304 |
Total Medical Submitted Charge Amount |
529502.2 |
Total Medical Medicare Allowed Amount |
94182.56 |
Total Medical Medicare Payment Amount |
66027.8 |
Total Medical Medicare Standardized Payment Amount |
67000.89 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
52 |
Number Of Black or African American Beneficiaries |
202 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
4 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8434 |