National Provider Identifier [NPI]: |
1023214509 |
Last Name Of The Provider |
DYER |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5325 FARAON ST |
Street Address 2 Of The Provider |
MS 1020 DIVISION OF GENERAL AND GERIATRIC MEDICINE UNIV |
City Of The Provider |
SAINT JOSEPH |
Zip Code Of The Provider |
645063488 |
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 |
17 |
Number Of Services |
680 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
184957 |
Total Medicare Allowed Amount |
70088.37 |
Total Medicare Payment Amount |
53971.45 |
Total Medicare Standardized Payment Amount |
57071.26 |
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 |
17 |
Number Of Medical Services |
680 |
Number Of Medicare Beneficiaries With Medical Services |
288 |
Total Medical Submitted Charge Amount |
184957 |
Total Medical Medicare Allowed Amount |
70088.37 |
Total Medical Medicare Payment Amount |
53971.45 |
Total Medical Medicare Standardized Payment Amount |
57071.26 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
209 |
Number Of Black or African American Beneficiaries |
57 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.1005 |