National Provider Identifier [NPI]: |
1528197324 |
Last Name Of The Provider |
DOZIER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1640 AIRPORT RD NW |
Street Address 2 Of The Provider |
STE 110 |
City Of The Provider |
KENNESAW |
Zip Code Of The Provider |
301447038 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
277 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
394015 |
Total Medicare Allowed Amount |
41521.63 |
Total Medicare Payment Amount |
31412.77 |
Total Medicare Standardized Payment Amount |
31583.31 |
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 |
3 |
Number Of Medical Services |
277 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
394015 |
Total Medical Medicare Allowed Amount |
41521.63 |
Total Medical Medicare Payment Amount |
31412.77 |
Total Medical Medicare Standardized Payment Amount |
31583.31 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
151 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
152 |
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2484 |