National Provider Identifier [NPI]: |
1144250887 |
Last Name Of The Provider |
SPIRE |
First Name Of The Provider |
MOLLIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5701 DELMAR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST. LOUIS |
Zip Code Of The Provider |
631120937 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
2813 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
128205.15 |
Total Medicare Allowed Amount |
61512.46 |
Total Medicare Payment Amount |
44484.91 |
Total Medicare Standardized Payment Amount |
46069.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
1890 |
Number Of Medicare Beneficiaries With Drug Services |
101 |
Total Drug Submitted ChargeAmount |
8259 |
Total Drug Medicare AllowedAmount |
647.63 |
Total Drug Medicare PaymentAmount |
517.22 |
Total Drug Medicare Standardized Payment Amount |
517.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
106 |
Number Of Medical Services |
923 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
119946.15 |
Total Medical Medicare Allowed Amount |
60864.83 |
Total Medical Medicare Payment Amount |
43967.69 |
Total Medical Medicare Standardized Payment Amount |
45552.52 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
241 |
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 |
227 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0045 |