National Provider Identifier [NPI]: |
1659326312 |
Last Name Of The Provider |
TOTTEN |
First Name Of The Provider |
MATTHEW |
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 |
1607 S OLD MISSOURI RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGDALE |
Zip Code Of The Provider |
727645723 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1040 |
Number Of Medicare Beneficiaries |
134 |
Total Submitted Charge Amount |
84510.65 |
Total Medicare Allowed Amount |
49632.78 |
Total Medicare Payment Amount |
34515.78 |
Total Medicare Standardized Payment Amount |
40280.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
890.65 |
Total Drug Medicare AllowedAmount |
533.41 |
Total Drug Medicare PaymentAmount |
422.97 |
Total Drug Medicare Standardized Payment Amount |
422.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
1004 |
Number Of Medicare Beneficiaries With Medical Services |
134 |
Total Medical Submitted Charge Amount |
83620 |
Total Medical Medicare Allowed Amount |
49099.37 |
Total Medical Medicare Payment Amount |
34092.81 |
Total Medical Medicare Standardized Payment Amount |
39857.73 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
122 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2618 |