National Provider Identifier [NPI]: |
1497749733 |
Last Name Of The Provider |
HOBBY |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3207 COUNTRY CLUB DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
VALDOSTA |
Zip Code Of The Provider |
316051029 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
12928 |
Number Of Medicare Beneficiaries |
903 |
Total Submitted Charge Amount |
1202711.25 |
Total Medicare Allowed Amount |
392320.23 |
Total Medicare Payment Amount |
297165.62 |
Total Medicare Standardized Payment Amount |
313805.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
1307 |
Number Of Medicare Beneficiaries With Drug Services |
408 |
Total Drug Submitted ChargeAmount |
39307 |
Total Drug Medicare AllowedAmount |
23821.29 |
Total Drug Medicare PaymentAmount |
21176.1 |
Total Drug Medicare Standardized Payment Amount |
21176.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
83 |
Number Of Medical Services |
11621 |
Number Of Medicare Beneficiaries With Medical Services |
903 |
Total Medical Submitted Charge Amount |
1163404.25 |
Total Medical Medicare Allowed Amount |
368498.94 |
Total Medical Medicare Payment Amount |
275989.52 |
Total Medical Medicare Standardized Payment Amount |
292629.88 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
385 |
Number Of Beneficiaries Age 75 to 84 |
324 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
504 |
Number Of Male Beneficiaries |
399 |
Number Of Non Hispanic White Beneficiaries |
818 |
Number Of Black or African American Beneficiaries |
69 |
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 |
827 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.0572 |