National Provider Identifier [NPI]: |
1427159714 |
Last Name Of The Provider |
FELDER |
First Name Of The Provider |
GUY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2345 DOUGHERTY FERRY RD |
Street Address 2 Of The Provider |
EMERGENCY DEPARTMENT |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631223313 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
168 |
Number Of Medicare Beneficiaries |
134 |
Total Submitted Charge Amount |
143218 |
Total Medicare Allowed Amount |
21886.56 |
Total Medicare Payment Amount |
16861.98 |
Total Medicare Standardized Payment Amount |
16932.61 |
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 |
17 |
Number Of Medical Services |
168 |
Number Of Medicare Beneficiaries With Medical Services |
134 |
Total Medical Submitted Charge Amount |
143218 |
Total Medical Medicare Allowed Amount |
21886.56 |
Total Medical Medicare Payment Amount |
16861.98 |
Total Medical Medicare Standardized Payment Amount |
16932.61 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
118 |
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 |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2832 |