National Provider Identifier [NPI]: |
1386790988 |
Last Name Of The Provider |
FLYNN |
First Name Of The Provider |
ANN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 N 1900 E |
Street Address 2 Of The Provider |
SOM 4R118 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841320002 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
188 |
Number Of Medicare Beneficiaries |
106 |
Total Submitted Charge Amount |
146886.79 |
Total Medicare Allowed Amount |
26297.95 |
Total Medicare Payment Amount |
19573.11 |
Total Medicare Standardized Payment Amount |
21063.4 |
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 |
30 |
Number Of Medical Services |
188 |
Number Of Medicare Beneficiaries With Medical Services |
106 |
Total Medical Submitted Charge Amount |
146886.79 |
Total Medical Medicare Allowed Amount |
26297.95 |
Total Medical Medicare Payment Amount |
19573.11 |
Total Medical Medicare Standardized Payment Amount |
21063.4 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
0 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.139 |