National Provider Identifier [NPI]: |
1811102445 |
Last Name Of The Provider |
HOLLINGSHEAD |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4420 LAKE BOONE TRL |
Street Address 2 Of The Provider |
|
City Of The Provider |
RALEIGH |
Zip Code Of The Provider |
276077505 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
141 |
Number Of Services |
2756 |
Number Of Medicare Beneficiaries |
1785 |
Total Submitted Charge Amount |
619801.84 |
Total Medicare Allowed Amount |
136007.91 |
Total Medicare Payment Amount |
104419.81 |
Total Medicare Standardized Payment Amount |
111817.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
201 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
2499.84 |
Total Drug Medicare AllowedAmount |
190.7 |
Total Drug Medicare PaymentAmount |
148.56 |
Total Drug Medicare Standardized Payment Amount |
148.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
139 |
Number Of Medical Services |
2555 |
Number Of Medicare Beneficiaries With Medical Services |
1785 |
Total Medical Submitted Charge Amount |
617302 |
Total Medical Medicare Allowed Amount |
135817.21 |
Total Medical Medicare Payment Amount |
104271.25 |
Total Medical Medicare Standardized Payment Amount |
111669.2 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
253 |
Number Of Beneficiaries Age 65 to 74 |
708 |
Number Of Beneficiaries Age 75 to 84 |
504 |
Number Of Beneficiaries Age Greater 84 |
320 |
Number Of Female Beneficiaries |
1087 |
Number Of Male Beneficiaries |
698 |
Number Of Non Hispanic White Beneficiaries |
1402 |
Number Of Black or African American Beneficiaries |
303 |
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1493 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
292 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.6238 |