National Provider Identifier [NPI]: |
1508881194 |
Last Name Of The Provider |
LADEN |
First Name Of The Provider |
SAMUEL |
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 |
3001 W DR MARTIN LUTHER KING JR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076307 |
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 |
36 |
Number Of Services |
2931 |
Number Of Medicare Beneficiaries |
1232 |
Total Submitted Charge Amount |
436916 |
Total Medicare Allowed Amount |
83255.83 |
Total Medicare Payment Amount |
63538.32 |
Total Medicare Standardized Payment Amount |
51584 |
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 |
36 |
Number Of Medical Services |
2931 |
Number Of Medicare Beneficiaries With Medical Services |
1232 |
Total Medical Submitted Charge Amount |
436916 |
Total Medical Medicare Allowed Amount |
83255.83 |
Total Medical Medicare Payment Amount |
63538.32 |
Total Medical Medicare Standardized Payment Amount |
51584 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
482 |
Number Of Beneficiaries Age 75 to 84 |
422 |
Number Of Beneficiaries Age Greater 84 |
184 |
Number Of Female Beneficiaries |
690 |
Number Of Male Beneficiaries |
542 |
Number Of Non Hispanic White Beneficiaries |
934 |
Number Of Black or African American Beneficiaries |
129 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
147 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
986 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
246 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.495 |