National Provider Identifier [NPI]: |
1124176722 |
Last Name Of The Provider |
CHANCE |
First Name Of The Provider |
RACHEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
124 S MEMORIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PRATTVILLE |
Zip Code Of The Provider |
360673619 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1320 |
Number Of Medicare Beneficiaries |
441 |
Total Submitted Charge Amount |
310093.38 |
Total Medicare Allowed Amount |
128259.6 |
Total Medicare Payment Amount |
100401.02 |
Total Medicare Standardized Payment Amount |
106047.66 |
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 |
21 |
Number Of Medical Services |
1320 |
Number Of Medicare Beneficiaries With Medical Services |
441 |
Total Medical Submitted Charge Amount |
310093.38 |
Total Medical Medicare Allowed Amount |
128259.6 |
Total Medical Medicare Payment Amount |
100401.02 |
Total Medical Medicare Standardized Payment Amount |
106047.66 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
276 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
380 |
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 |
338 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7949 |