National Provider Identifier [NPI]: |
1578656138 |
Last Name Of The Provider |
HAYES |
First Name Of The Provider |
ALISA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
652120001 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
226 |
Number Of Medicare Beneficiaries |
199 |
Total Submitted Charge Amount |
72512 |
Total Medicare Allowed Amount |
26920.58 |
Total Medicare Payment Amount |
20588.26 |
Total Medicare Standardized Payment Amount |
21143.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
226 |
Number Of Medicare Beneficiaries With Medical Services |
199 |
Total Medical Submitted Charge Amount |
72512 |
Total Medical Medicare Allowed Amount |
26920.58 |
Total Medical Medicare Payment Amount |
20588.26 |
Total Medical Medicare Standardized Payment Amount |
21143.34 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
164 |
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 |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9519 |