National Provider Identifier [NPI]: |
1477530533 |
Last Name Of The Provider |
KEATON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 ST.SEBASTIAN WAY |
Street Address 2 Of The Provider |
SUITE 3A |
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
30901 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
167 |
Number Of Services |
161158 |
Number Of Medicare Beneficiaries |
765 |
Total Submitted Charge Amount |
4662797 |
Total Medicare Allowed Amount |
2247866.71 |
Total Medicare Payment Amount |
1754987.45 |
Total Medicare Standardized Payment Amount |
1768811.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
82 |
Number Of Drug Services |
150028 |
Number Of Medicare Beneficiaries With Drug Services |
306 |
Total Drug Submitted ChargeAmount |
3486602 |
Total Drug Medicare AllowedAmount |
1791153.25 |
Total Drug Medicare PaymentAmount |
1396321.41 |
Total Drug Medicare Standardized Payment Amount |
1396321.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
85 |
Number Of Medical Services |
11130 |
Number Of Medicare Beneficiaries With Medical Services |
765 |
Total Medical Submitted Charge Amount |
1176195 |
Total Medical Medicare Allowed Amount |
456713.46 |
Total Medical Medicare Payment Amount |
358666.04 |
Total Medical Medicare Standardized Payment Amount |
372490.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
379 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
536 |
Number Of Male Beneficiaries |
229 |
Number Of Non Hispanic White Beneficiaries |
645 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
687 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
54 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.4287 |