National Provider Identifier [NPI]: |
1952300469 |
Last Name Of The Provider |
CAVALIERE |
First Name Of The Provider |
LUDWIG |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
640 MARTIN LUTHER KING JR BLVD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
MACON |
Zip Code Of The Provider |
312013206 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
11476 |
Number Of Medicare Beneficiaries |
712 |
Total Submitted Charge Amount |
1544497.65 |
Total Medicare Allowed Amount |
528466.87 |
Total Medicare Payment Amount |
415810.38 |
Total Medicare Standardized Payment Amount |
433738.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
2700 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
108000 |
Total Drug Medicare AllowedAmount |
30961.66 |
Total Drug Medicare PaymentAmount |
23845.35 |
Total Drug Medicare Standardized Payment Amount |
23845.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
8776 |
Number Of Medicare Beneficiaries With Medical Services |
712 |
Total Medical Submitted Charge Amount |
1436497.65 |
Total Medical Medicare Allowed Amount |
497505.21 |
Total Medical Medicare Payment Amount |
391965.03 |
Total Medical Medicare Standardized Payment Amount |
409893.26 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
159 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
236 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
352 |
Number Of Male Beneficiaries |
360 |
Number Of Non Hispanic White Beneficiaries |
444 |
Number Of Black or African American Beneficiaries |
253 |
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 |
559 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.311 |