National Provider Identifier [NPI]: |
1699931576 |
Last Name Of The Provider |
MAGILL |
First Name Of The Provider |
RAY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1364 CLIFTON RD NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303221059 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiologist Assistants |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
295 |
Number Of Medicare Beneficiaries |
175 |
Total Submitted Charge Amount |
369180 |
Total Medicare Allowed Amount |
34755.98 |
Total Medicare Payment Amount |
27145.8 |
Total Medicare Standardized Payment Amount |
27201.24 |
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 |
40 |
Number Of Medical Services |
295 |
Number Of Medicare Beneficiaries With Medical Services |
175 |
Total Medical Submitted Charge Amount |
369180 |
Total Medical Medicare Allowed Amount |
34755.98 |
Total Medical Medicare Payment Amount |
27145.8 |
Total Medical Medicare Standardized Payment Amount |
27201.24 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
136 |
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 |
135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
61 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0377 |