National Provider Identifier [NPI]: |
1447240510 |
Last Name Of The Provider |
FEATHERSTON |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 PRUDENTIAL DR STE 304 |
Street Address 2 Of The Provider |
CREDENTIALING DEPARTMENT |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322078205 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1241 |
Number Of Medicare Beneficiaries |
371 |
Total Submitted Charge Amount |
226229 |
Total Medicare Allowed Amount |
121556.51 |
Total Medicare Payment Amount |
95142.53 |
Total Medicare Standardized Payment Amount |
96538.18 |
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 |
30 |
Number Of Medical Services |
1241 |
Number Of Medicare Beneficiaries With Medical Services |
371 |
Total Medical Submitted Charge Amount |
226229 |
Total Medical Medicare Allowed Amount |
121556.51 |
Total Medical Medicare Payment Amount |
95142.53 |
Total Medical Medicare Standardized Payment Amount |
96538.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
305 |
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 |
229 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3209 |