National Provider Identifier [NPI]: |
1003844754 |
Last Name Of The Provider |
CHEATHAM |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1813 BELTLINE RD SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
356015506 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
5513 |
Number Of Medicare Beneficiaries |
1028 |
Total Submitted Charge Amount |
504160 |
Total Medicare Allowed Amount |
375564.85 |
Total Medicare Payment Amount |
274305.8 |
Total Medicare Standardized Payment Amount |
296490.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
213 |
Number Of Medicare Beneficiaries With Drug Services |
77 |
Total Drug Submitted ChargeAmount |
6272 |
Total Drug Medicare AllowedAmount |
3057.08 |
Total Drug Medicare PaymentAmount |
2350.47 |
Total Drug Medicare Standardized Payment Amount |
2350.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
104 |
Number Of Medical Services |
5300 |
Number Of Medicare Beneficiaries With Medical Services |
1028 |
Total Medical Submitted Charge Amount |
497888 |
Total Medical Medicare Allowed Amount |
372507.77 |
Total Medical Medicare Payment Amount |
271955.33 |
Total Medical Medicare Standardized Payment Amount |
294140.09 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
221 |
Number Of Beneficiaries Age 65 to 74 |
413 |
Number Of Beneficiaries Age 75 to 84 |
264 |
Number Of Beneficiaries Age Greater 84 |
130 |
Number Of Female Beneficiaries |
616 |
Number Of Male Beneficiaries |
412 |
Number Of Non Hispanic White Beneficiaries |
925 |
Number Of Black or African American Beneficiaries |
92 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
724 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
304 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5462 |