National Provider Identifier [NPI]: |
1326067737 |
Last Name Of The Provider |
HOLLIDAY |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PHD, MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4571 SUMMER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381224135 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1152 |
Number Of Medicare Beneficiaries |
706 |
Total Submitted Charge Amount |
110168 |
Total Medicare Allowed Amount |
97813.01 |
Total Medicare Payment Amount |
65982.54 |
Total Medicare Standardized Payment Amount |
79614.42 |
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 |
14 |
Number Of Medical Services |
1152 |
Number Of Medicare Beneficiaries With Medical Services |
706 |
Total Medical Submitted Charge Amount |
110168 |
Total Medical Medicare Allowed Amount |
97813.01 |
Total Medical Medicare Payment Amount |
65982.54 |
Total Medical Medicare Standardized Payment Amount |
79614.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
314 |
Number Of Beneficiaries Age 75 to 84 |
239 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
411 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
643 |
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 |
558 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
148 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0864 |