National Provider Identifier [NPI]: |
1336234459 |
Last Name Of The Provider |
SWIFT |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 15TH STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
30912 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
179 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
24032 |
Total Medicare Allowed Amount |
11156.33 |
Total Medicare Payment Amount |
7578.34 |
Total Medicare Standardized Payment Amount |
8050.24 |
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 |
7 |
Number Of Medical Services |
179 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
24032 |
Total Medical Medicare Allowed Amount |
11156.33 |
Total Medical Medicare Payment Amount |
7578.34 |
Total Medical Medicare Standardized Payment Amount |
8050.24 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
90 |
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 |
89 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
1.4279 |