National Provider Identifier [NPI]: |
1942239496 |
Last Name Of The Provider |
GRAY |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16 S EUTAW ST |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212011606 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
913 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
143635 |
Total Medicare Allowed Amount |
70878.93 |
Total Medicare Payment Amount |
52579.24 |
Total Medicare Standardized Payment Amount |
50512.1 |
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 |
37 |
Number Of Medical Services |
913 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
143635 |
Total Medical Medicare Allowed Amount |
70878.93 |
Total Medical Medicare Payment Amount |
52579.24 |
Total Medical Medicare Standardized Payment Amount |
50512.1 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
309 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
215 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.2606 |