National Provider Identifier [NPI]: |
1922181940 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11810 WILLS RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
ALPHARETTA |
Zip Code Of The Provider |
300092081 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
17185 |
Number Of Medicare Beneficiaries |
4718 |
Total Submitted Charge Amount |
3358583.39 |
Total Medicare Allowed Amount |
952103.29 |
Total Medicare Payment Amount |
734567.99 |
Total Medicare Standardized Payment Amount |
518247.08 |
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 |
13 |
Number Of Medical Services |
17185 |
Number Of Medicare Beneficiaries With Medical Services |
4718 |
Total Medical Submitted Charge Amount |
3358583.39 |
Total Medical Medicare Allowed Amount |
952103.29 |
Total Medical Medicare Payment Amount |
734567.99 |
Total Medical Medicare Standardized Payment Amount |
518247.08 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
607 |
Number Of Beneficiaries Age 65 to 74 |
2432 |
Number Of Beneficiaries Age 75 to 84 |
1440 |
Number Of Beneficiaries Age Greater 84 |
239 |
Number Of Female Beneficiaries |
2653 |
Number Of Male Beneficiaries |
2065 |
Number Of Non Hispanic White Beneficiaries |
3801 |
Number Of Black or African American Beneficiaries |
387 |
Number Of AsianPacific Islander Beneficiaries |
145 |
Number Of Hispanic Beneficiaries |
271 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
3818 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
900 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0504 |