National Provider Identifier [NPI]: |
1942292446 |
Last Name Of The Provider |
EVANS |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1160 EAST 3900 SOUTH |
Street Address 2 Of The Provider |
SUITE 5000 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841241275 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
4594 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
450220.85 |
Total Medicare Allowed Amount |
214758.41 |
Total Medicare Payment Amount |
162310.83 |
Total Medicare Standardized Payment Amount |
166287.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3442 |
Number Of Medicare Beneficiaries With Drug Services |
133 |
Total Drug Submitted ChargeAmount |
65469 |
Total Drug Medicare AllowedAmount |
42619.39 |
Total Drug Medicare PaymentAmount |
32115.41 |
Total Drug Medicare Standardized Payment Amount |
32115.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1152 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
384751.85 |
Total Medical Medicare Allowed Amount |
172139.02 |
Total Medical Medicare Payment Amount |
130195.42 |
Total Medical Medicare Standardized Payment Amount |
134171.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
161 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0419 |