National Provider Identifier [NPI]: |
1841344108 |
Last Name Of The Provider |
CHECK |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4700 WATERS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314046220 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
4460 |
Number Of Medicare Beneficiaries |
1524 |
Total Submitted Charge Amount |
513258 |
Total Medicare Allowed Amount |
169792.04 |
Total Medicare Payment Amount |
131506.82 |
Total Medicare Standardized Payment Amount |
106463.63 |
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 |
31 |
Number Of Medical Services |
4460 |
Number Of Medicare Beneficiaries With Medical Services |
1524 |
Total Medical Submitted Charge Amount |
513258 |
Total Medical Medicare Allowed Amount |
169792.04 |
Total Medical Medicare Payment Amount |
131506.82 |
Total Medical Medicare Standardized Payment Amount |
106463.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
316 |
Number Of Beneficiaries Age 65 to 74 |
687 |
Number Of Beneficiaries Age 75 to 84 |
395 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
911 |
Number Of Male Beneficiaries |
613 |
Number Of Non Hispanic White Beneficiaries |
1145 |
Number Of Black or African American Beneficiaries |
341 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
380 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7912 |