National Provider Identifier [NPI]: |
1619039666 |
Last Name Of The Provider |
LOCKHART |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7191 CAHABA VALLEY RD |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352426402 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
679 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
53788.01 |
Total Medicare Allowed Amount |
46112.63 |
Total Medicare Payment Amount |
32506.65 |
Total Medicare Standardized Payment Amount |
36377.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
92 |
Number Of Medicare Beneficiaries With Drug Services |
71 |
Total Drug Submitted ChargeAmount |
2942 |
Total Drug Medicare AllowedAmount |
2631.88 |
Total Drug Medicare PaymentAmount |
2558.72 |
Total Drug Medicare Standardized Payment Amount |
2558.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
587 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
50846.01 |
Total Medical Medicare Allowed Amount |
43480.75 |
Total Medical Medicare Payment Amount |
29947.93 |
Total Medical Medicare Standardized Payment Amount |
33818.69 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
14 |
Number Of Non Hispanic White Beneficiaries |
150 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7595 |