National Provider Identifier [NPI]: |
1568573152 |
Last Name Of The Provider |
MAYNARD |
First Name Of The Provider |
PAUL |
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 |
108 TRIVETTE DR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
PIKEVILLE |
Zip Code Of The Provider |
415011343 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
2671 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
290491 |
Total Medicare Allowed Amount |
129065.17 |
Total Medicare Payment Amount |
91853.17 |
Total Medicare Standardized Payment Amount |
96642.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
183 |
Number Of Medicare Beneficiaries With Drug Services |
151 |
Total Drug Submitted ChargeAmount |
7750 |
Total Drug Medicare AllowedAmount |
2197.84 |
Total Drug Medicare PaymentAmount |
2126.42 |
Total Drug Medicare Standardized Payment Amount |
2126.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
62 |
Number Of Medical Services |
2488 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
282741 |
Total Medical Medicare Allowed Amount |
126867.33 |
Total Medical Medicare Payment Amount |
89726.75 |
Total Medical Medicare Standardized Payment Amount |
94515.9 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
31 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4336 |