National Provider Identifier [NPI]: |
1427082726 |
Last Name Of The Provider |
ADAMS |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
210 HOSPITAL CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHOCTAW |
Zip Code Of The Provider |
393506781 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
500 |
Number Of Medicare Beneficiaries |
202 |
Total Submitted Charge Amount |
44813.31 |
Total Medicare Allowed Amount |
33592.73 |
Total Medicare Payment Amount |
25058.08 |
Total Medicare Standardized Payment Amount |
26474.96 |
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 |
18 |
Number Of Medical Services |
500 |
Number Of Medicare Beneficiaries With Medical Services |
202 |
Total Medical Submitted Charge Amount |
44813.31 |
Total Medical Medicare Allowed Amount |
33592.73 |
Total Medical Medicare Payment Amount |
25058.08 |
Total Medical Medicare Standardized Payment Amount |
26474.96 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
100 |
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 |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4425 |