National Provider Identifier [NPI]: |
1194733907 |
Last Name Of The Provider |
JAIN |
First Name Of The Provider |
PRAVIN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
380 HOSPITAL DRIVE |
Street Address 2 Of The Provider |
SUITE 410 |
City Of The Provider |
MACON |
Zip Code Of The Provider |
31217 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
811 |
Number Of Medicare Beneficiaries |
676 |
Total Submitted Charge Amount |
773761.33 |
Total Medicare Allowed Amount |
95834.79 |
Total Medicare Payment Amount |
74471.49 |
Total Medicare Standardized Payment Amount |
76629.78 |
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 |
98 |
Number Of Medical Services |
811 |
Number Of Medicare Beneficiaries With Medical Services |
676 |
Total Medical Submitted Charge Amount |
773761.33 |
Total Medical Medicare Allowed Amount |
95834.79 |
Total Medical Medicare Payment Amount |
74471.49 |
Total Medical Medicare Standardized Payment Amount |
76629.78 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
271 |
Number Of Beneficiaries Age 75 to 84 |
199 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
341 |
Number Of Male Beneficiaries |
335 |
Number Of Non Hispanic White Beneficiaries |
545 |
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 |
521 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9109 |