National Provider Identifier [NPI]: |
1598703795 |
Last Name Of The Provider |
ROBERTS |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5959 PARK AVE |
Street Address 2 Of The Provider |
RADIOLOGY DEPARTMENT |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381195200 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
254 |
Number Of Services |
8532 |
Number Of Medicare Beneficiaries |
2544 |
Total Submitted Charge Amount |
863278.2 |
Total Medicare Allowed Amount |
178255.12 |
Total Medicare Payment Amount |
134760.21 |
Total Medicare Standardized Payment Amount |
147272.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
4461 |
Number Of Medicare Beneficiaries With Drug Services |
56 |
Total Drug Submitted ChargeAmount |
10109.2 |
Total Drug Medicare AllowedAmount |
1853.81 |
Total Drug Medicare PaymentAmount |
1453.31 |
Total Drug Medicare Standardized Payment Amount |
1453.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
249 |
Number Of Medical Services |
4071 |
Number Of Medicare Beneficiaries With Medical Services |
2544 |
Total Medical Submitted Charge Amount |
853169 |
Total Medical Medicare Allowed Amount |
176401.31 |
Total Medical Medicare Payment Amount |
133306.9 |
Total Medical Medicare Standardized Payment Amount |
145819.08 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
577 |
Number Of Beneficiaries Age 65 to 74 |
947 |
Number Of Beneficiaries Age 75 to 84 |
663 |
Number Of Beneficiaries Age Greater 84 |
357 |
Number Of Female Beneficiaries |
1652 |
Number Of Male Beneficiaries |
892 |
Number Of Non Hispanic White Beneficiaries |
1698 |
Number Of Black or African American Beneficiaries |
777 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1756 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
788 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8145 |