National Provider Identifier [NPI]: |
1164424461 |
Last Name Of The Provider |
GLASCOCK |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 FIRST CAPITOL DRIVE |
Street Address 2 Of The Provider |
SUITE 270 |
City Of The Provider |
ST CHARLES |
Zip Code Of The Provider |
63301 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
2574 |
Number Of Medicare Beneficiaries |
410 |
Total Submitted Charge Amount |
711660.12 |
Total Medicare Allowed Amount |
275353.45 |
Total Medicare Payment Amount |
207357.34 |
Total Medicare Standardized Payment Amount |
211602.23 |
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 |
68 |
Number Of Medical Services |
2574 |
Number Of Medicare Beneficiaries With Medical Services |
410 |
Total Medical Submitted Charge Amount |
711660.12 |
Total Medical Medicare Allowed Amount |
275353.45 |
Total Medical Medicare Payment Amount |
207357.34 |
Total Medical Medicare Standardized Payment Amount |
211602.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
369 |
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 |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
53 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8341 |