National Provider Identifier [NPI]: |
1740268002 |
Last Name Of The Provider |
MEHLHAUS |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 S STORY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOONE |
Zip Code Of The Provider |
500364739 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
166 |
Number Of Services |
6034 |
Number Of Medicare Beneficiaries |
530 |
Total Submitted Charge Amount |
550446 |
Total Medicare Allowed Amount |
226217.38 |
Total Medicare Payment Amount |
166451.26 |
Total Medicare Standardized Payment Amount |
178720.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
300 |
Number Of Medicare Beneficiaries With Drug Services |
173 |
Total Drug Submitted ChargeAmount |
10061 |
Total Drug Medicare AllowedAmount |
6017.95 |
Total Drug Medicare PaymentAmount |
5765.34 |
Total Drug Medicare Standardized Payment Amount |
5765.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
158 |
Number Of Medical Services |
5734 |
Number Of Medicare Beneficiaries With Medical Services |
530 |
Total Medical Submitted Charge Amount |
540385 |
Total Medical Medicare Allowed Amount |
220199.43 |
Total Medical Medicare Payment Amount |
160685.92 |
Total Medical Medicare Standardized Payment Amount |
172955.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
157 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
516 |
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 |
439 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0186 |