National Provider Identifier [NPI]: |
1104885581 |
Last Name Of The Provider |
NUNLEY |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2710 MEDICAL LANE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROGERS |
Zip Code Of The Provider |
727581452 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
570 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
244331 |
Total Medicare Allowed Amount |
56724.18 |
Total Medicare Payment Amount |
43619.77 |
Total Medicare Standardized Payment Amount |
43571.54 |
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 |
73 |
Number Of Medical Services |
570 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
244331 |
Total Medical Medicare Allowed Amount |
56724.18 |
Total Medical Medicare Payment Amount |
43619.77 |
Total Medical Medicare Standardized Payment Amount |
43571.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1588 |