National Provider Identifier [NPI]: |
1578637542 |
Last Name Of The Provider |
MCINTIRE |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3011 HAMPTON AVE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
BRUNSWICK |
Zip Code Of The Provider |
315204264 |
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 |
2946 |
Number Of Medicare Beneficiaries |
927 |
Total Submitted Charge Amount |
537561 |
Total Medicare Allowed Amount |
152185.41 |
Total Medicare Payment Amount |
118001.08 |
Total Medicare Standardized Payment Amount |
95931.58 |
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 |
2946 |
Number Of Medicare Beneficiaries With Medical Services |
927 |
Total Medical Submitted Charge Amount |
537561 |
Total Medical Medicare Allowed Amount |
152185.41 |
Total Medical Medicare Payment Amount |
118001.08 |
Total Medical Medicare Standardized Payment Amount |
95931.58 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
162 |
Number Of Beneficiaries Age 65 to 74 |
437 |
Number Of Beneficiaries Age 75 to 84 |
269 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
522 |
Number Of Male Beneficiaries |
405 |
Number Of Non Hispanic White Beneficiaries |
767 |
Number Of Black or African American Beneficiaries |
141 |
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 |
685 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
242 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3227 |