National Provider Identifier [NPI]: |
1730166307 |
Last Name Of The Provider |
BENNETT |
First Name Of The Provider |
WESLEY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 22ND AVE |
Street Address 2 Of The Provider |
MEDICAL TOWERS III |
City Of The Provider |
MERIDIAN |
Zip Code Of The Provider |
393013223 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
116 |
Number Of Services |
9035 |
Number Of Medicare Beneficiaries |
1291 |
Total Submitted Charge Amount |
3212028 |
Total Medicare Allowed Amount |
753007.15 |
Total Medicare Payment Amount |
563592.59 |
Total Medicare Standardized Payment Amount |
629754.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
503 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
38676 |
Total Drug Medicare AllowedAmount |
25558.29 |
Total Drug Medicare PaymentAmount |
19734.04 |
Total Drug Medicare Standardized Payment Amount |
19734.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
112 |
Number Of Medical Services |
8532 |
Number Of Medicare Beneficiaries With Medical Services |
1291 |
Total Medical Submitted Charge Amount |
3173352 |
Total Medical Medicare Allowed Amount |
727448.86 |
Total Medical Medicare Payment Amount |
543858.55 |
Total Medical Medicare Standardized Payment Amount |
610020.55 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
481 |
Number Of Beneficiaries Age 75 to 84 |
460 |
Number Of Beneficiaries Age Greater 84 |
205 |
Number Of Female Beneficiaries |
661 |
Number Of Male Beneficiaries |
630 |
Number Of Non Hispanic White Beneficiaries |
996 |
Number Of Black or African American Beneficiaries |
248 |
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 |
991 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
300 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4761 |