National Provider Identifier [NPI]: |
1881642551 |
Last Name Of The Provider |
REYNOLDS |
First Name Of The Provider |
GLENN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 26TH ST S |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREAT FALLS |
Zip Code Of The Provider |
594055161 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
2151 |
Number Of Medicare Beneficiaries |
1109 |
Total Submitted Charge Amount |
313809 |
Total Medicare Allowed Amount |
155176.38 |
Total Medicare Payment Amount |
118116.33 |
Total Medicare Standardized Payment Amount |
125094.8 |
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 |
66 |
Number Of Medical Services |
2151 |
Number Of Medicare Beneficiaries With Medical Services |
1109 |
Total Medical Submitted Charge Amount |
313809 |
Total Medical Medicare Allowed Amount |
155176.38 |
Total Medical Medicare Payment Amount |
118116.33 |
Total Medical Medicare Standardized Payment Amount |
125094.8 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
375 |
Number Of Beneficiaries Age 75 to 84 |
364 |
Number Of Beneficiaries Age Greater 84 |
213 |
Number Of Female Beneficiaries |
609 |
Number Of Male Beneficiaries |
500 |
Number Of Non Hispanic White Beneficiaries |
1032 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
829 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
280 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8208 |