National Provider Identifier [NPI]: |
1801814330 |
Last Name Of The Provider |
CARPENTER |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4921 PARKVIEW PL |
Street Address 2 Of The Provider |
STE 6C |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101032 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1117 |
Number Of Medicare Beneficiaries |
512 |
Total Submitted Charge Amount |
204780 |
Total Medicare Allowed Amount |
111002.8 |
Total Medicare Payment Amount |
80113.65 |
Total Medicare Standardized Payment Amount |
82309.63 |
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 |
15 |
Number Of Medical Services |
1117 |
Number Of Medicare Beneficiaries With Medical Services |
512 |
Total Medical Submitted Charge Amount |
204780 |
Total Medical Medicare Allowed Amount |
111002.8 |
Total Medical Medicare Payment Amount |
80113.65 |
Total Medical Medicare Standardized Payment Amount |
82309.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
134 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
295 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
396 |
Number Of Black or African American Beneficiaries |
99 |
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 |
388 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
59 |
Average HCC Risk Score Of Beneficiaries |
1.7626 |