National Provider Identifier [NPI]: |
1003821802 |
Last Name Of The Provider |
LOOP |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1211 MISSOURI AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST PLAINS |
Zip Code Of The Provider |
657752105 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1770 |
Number Of Medicare Beneficiaries |
407 |
Total Submitted Charge Amount |
278860 |
Total Medicare Allowed Amount |
151377.9 |
Total Medicare Payment Amount |
115998.91 |
Total Medicare Standardized Payment Amount |
123942.48 |
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 |
12 |
Number Of Medical Services |
1770 |
Number Of Medicare Beneficiaries With Medical Services |
407 |
Total Medical Submitted Charge Amount |
278860 |
Total Medical Medicare Allowed Amount |
151377.9 |
Total Medical Medicare Payment Amount |
115998.91 |
Total Medical Medicare Standardized Payment Amount |
123942.48 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
237 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
301 |
Number Of Black or African American Beneficiaries |
94 |
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 |
204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
61 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4559 |