National Provider Identifier [NPI]: |
1689623753 |
Last Name Of The Provider |
MARSHALL |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
652120001 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
346 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
103339 |
Total Medicare Allowed Amount |
32571.42 |
Total Medicare Payment Amount |
24002.82 |
Total Medicare Standardized Payment Amount |
25657.91 |
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 |
18 |
Number Of Medical Services |
346 |
Number Of Medicare Beneficiaries With Medical Services |
260 |
Total Medical Submitted Charge Amount |
103339 |
Total Medical Medicare Allowed Amount |
32571.42 |
Total Medical Medicare Payment Amount |
24002.82 |
Total Medical Medicare Standardized Payment Amount |
25657.91 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
166 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
237 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2683 |