National Provider Identifier [NPI]: |
1821280769 |
Last Name Of The Provider |
CLARY |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HOSPITAL DRIVE |
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 |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
801 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
164761 |
Total Medicare Allowed Amount |
70684.98 |
Total Medicare Payment Amount |
54673.96 |
Total Medicare Standardized Payment Amount |
57088.84 |
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 |
23 |
Number Of Medical Services |
801 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
164761 |
Total Medical Medicare Allowed Amount |
70684.98 |
Total Medical Medicare Payment Amount |
54673.96 |
Total Medical Medicare Standardized Payment Amount |
57088.84 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
214 |
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 |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
59 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.8538 |