National Provider Identifier [NPI]: |
1538322862 |
Last Name Of The Provider |
VANN |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1007 GOODYEAR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GADSDEN |
Zip Code Of The Provider |
359031195 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1045 |
Number Of Medicare Beneficiaries |
840 |
Total Submitted Charge Amount |
709803.5 |
Total Medicare Allowed Amount |
145572.31 |
Total Medicare Payment Amount |
110134.54 |
Total Medicare Standardized Payment Amount |
116607.26 |
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 |
28 |
Number Of Medical Services |
1045 |
Number Of Medicare Beneficiaries With Medical Services |
840 |
Total Medical Submitted Charge Amount |
709803.5 |
Total Medical Medicare Allowed Amount |
145572.31 |
Total Medical Medicare Payment Amount |
110134.54 |
Total Medical Medicare Standardized Payment Amount |
116607.26 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
268 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
516 |
Number Of Male Beneficiaries |
324 |
Number Of Non Hispanic White Beneficiaries |
823 |
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 |
450 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
390 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6277 |