National Provider Identifier [NPI]: |
1508824228 |
Last Name Of The Provider |
OLAUGHLIN |
First Name Of The Provider |
SABINE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 PRUDENTIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
32207 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
4534 |
Number Of Medicare Beneficiaries |
1620 |
Total Submitted Charge Amount |
712517.49 |
Total Medicare Allowed Amount |
162451.6 |
Total Medicare Payment Amount |
126493.24 |
Total Medicare Standardized Payment Amount |
106811.8 |
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 |
44 |
Number Of Medical Services |
4534 |
Number Of Medicare Beneficiaries With Medical Services |
1620 |
Total Medical Submitted Charge Amount |
712517.49 |
Total Medical Medicare Allowed Amount |
162451.6 |
Total Medical Medicare Payment Amount |
126493.24 |
Total Medical Medicare Standardized Payment Amount |
106811.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
209 |
Number Of Beneficiaries Age 65 to 74 |
747 |
Number Of Beneficiaries Age 75 to 84 |
488 |
Number Of Beneficiaries Age Greater 84 |
176 |
Number Of Female Beneficiaries |
910 |
Number Of Male Beneficiaries |
710 |
Number Of Non Hispanic White Beneficiaries |
1336 |
Number Of Black or African American Beneficiaries |
191 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
37 |
Number Of Beneficiaries With Medicare Only Entitlement |
1377 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6435 |