National Provider Identifier [NPI]: |
1508061755 |
Last Name Of The Provider |
TAYLOR |
First Name Of The Provider |
SHANNA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 E WOOD ST |
Street Address 2 Of The Provider |
SUITE 401 |
City Of The Provider |
SPARTANBURG |
Zip Code Of The Provider |
293033040 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1124 |
Number Of Medicare Beneficiaries |
475 |
Total Submitted Charge Amount |
223225 |
Total Medicare Allowed Amount |
95953.25 |
Total Medicare Payment Amount |
72752.36 |
Total Medicare Standardized Payment Amount |
77184 |
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 |
21 |
Number Of Medical Services |
1124 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
223225 |
Total Medical Medicare Allowed Amount |
95953.25 |
Total Medical Medicare Payment Amount |
72752.36 |
Total Medical Medicare Standardized Payment Amount |
77184 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
402 |
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 |
344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.2884 |