National Provider Identifier [NPI]: |
1952492969 |
Last Name Of The Provider |
JOURNAGAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 S KINGSHIGHWAY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101014 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
638 |
Number Of Medicare Beneficiaries |
586 |
Total Submitted Charge Amount |
415632 |
Total Medicare Allowed Amount |
100836.42 |
Total Medicare Payment Amount |
77007.56 |
Total Medicare Standardized Payment Amount |
77339.62 |
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 |
20 |
Number Of Medical Services |
638 |
Number Of Medicare Beneficiaries With Medical Services |
586 |
Total Medical Submitted Charge Amount |
415632 |
Total Medical Medicare Allowed Amount |
100836.42 |
Total Medical Medicare Payment Amount |
77007.56 |
Total Medical Medicare Standardized Payment Amount |
77339.62 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
343 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
495 |
Number Of Black or African American Beneficiaries |
73 |
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 |
448 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0365 |