National Provider Identifier [NPI]: |
1912095100 |
Last Name Of The Provider |
TALBOT |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
40 FRANKLIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HATTIESBURG |
Zip Code Of The Provider |
394021318 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
458 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
515299.57 |
Total Medicare Allowed Amount |
69421.58 |
Total Medicare Payment Amount |
54021.04 |
Total Medicare Standardized Payment Amount |
58177.14 |
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 |
76 |
Number Of Medical Services |
458 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
515299.57 |
Total Medical Medicare Allowed Amount |
69421.58 |
Total Medical Medicare Payment Amount |
54021.04 |
Total Medical Medicare Standardized Payment Amount |
58177.14 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9768 |