National Provider Identifier [NPI]: |
1134149321 |
Last Name Of The Provider |
TRAVIS |
First Name Of The Provider |
AARON |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2820 E. ROCK HAVEN RD. |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
HARRISONVILLE |
Zip Code Of The Provider |
647012082 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
4687 |
Number Of Medicare Beneficiaries |
805 |
Total Submitted Charge Amount |
477924 |
Total Medicare Allowed Amount |
236876.69 |
Total Medicare Payment Amount |
170800.17 |
Total Medicare Standardized Payment Amount |
184917.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
680 |
Number Of Medicare Beneficiaries With Drug Services |
157 |
Total Drug Submitted ChargeAmount |
15336 |
Total Drug Medicare AllowedAmount |
11422.06 |
Total Drug Medicare PaymentAmount |
9628.99 |
Total Drug Medicare Standardized Payment Amount |
9628.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
4007 |
Number Of Medicare Beneficiaries With Medical Services |
805 |
Total Medical Submitted Charge Amount |
462588 |
Total Medical Medicare Allowed Amount |
225454.63 |
Total Medical Medicare Payment Amount |
161171.18 |
Total Medical Medicare Standardized Payment Amount |
175288.11 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
140 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
251 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
466 |
Number Of Male Beneficiaries |
339 |
Number Of Non Hispanic White Beneficiaries |
784 |
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 |
644 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3376 |