National Provider Identifier [NPI]: |
1205889524 |
Last Name Of The Provider |
CONRAD |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2190 HIGHWAY 85 N |
Street Address 2 Of The Provider |
|
City Of The Provider |
NICEVILLE |
Zip Code Of The Provider |
325781045 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
881 |
Number Of Medicare Beneficiaries |
580 |
Total Submitted Charge Amount |
469937 |
Total Medicare Allowed Amount |
89090.96 |
Total Medicare Payment Amount |
67338.36 |
Total Medicare Standardized Payment Amount |
69113.84 |
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 |
38 |
Number Of Medical Services |
881 |
Number Of Medicare Beneficiaries With Medical Services |
580 |
Total Medical Submitted Charge Amount |
469937 |
Total Medical Medicare Allowed Amount |
89090.96 |
Total Medical Medicare Payment Amount |
67338.36 |
Total Medical Medicare Standardized Payment Amount |
69113.84 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
177 |
Number Of Beneficiaries Age 65 to 74 |
186 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
233 |
Number Of Non Hispanic White Beneficiaries |
433 |
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 |
301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
279 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6638 |