National Provider Identifier [NPI]: |
1437140373 |
Last Name Of The Provider |
DAVID |
First Name Of The Provider |
ALEX |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 LILE CT |
Street Address 2 Of The Provider |
SUITE 102B |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722056221 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
6360 |
Number Of Medicare Beneficiaries |
1481 |
Total Submitted Charge Amount |
636779.44 |
Total Medicare Allowed Amount |
492888.91 |
Total Medicare Payment Amount |
372782.53 |
Total Medicare Standardized Payment Amount |
402895.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1355 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
24380 |
Total Drug Medicare AllowedAmount |
15516.92 |
Total Drug Medicare PaymentAmount |
11320.12 |
Total Drug Medicare Standardized Payment Amount |
11320.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
5005 |
Number Of Medicare Beneficiaries With Medical Services |
1481 |
Total Medical Submitted Charge Amount |
612399.44 |
Total Medical Medicare Allowed Amount |
477371.99 |
Total Medical Medicare Payment Amount |
361462.41 |
Total Medical Medicare Standardized Payment Amount |
391575.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
352 |
Number Of Beneficiaries Age 65 to 74 |
489 |
Number Of Beneficiaries Age 75 to 84 |
435 |
Number Of Beneficiaries Age Greater 84 |
205 |
Number Of Female Beneficiaries |
754 |
Number Of Male Beneficiaries |
727 |
Number Of Non Hispanic White Beneficiaries |
1144 |
Number Of Black or African American Beneficiaries |
296 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1023 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
458 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.3615 |