National Provider Identifier [NPI]: |
1609842137 |
Last Name Of The Provider |
STOUT |
First Name Of The Provider |
PAUL |
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 |
1 SAINT VINCENT CIR |
Street Address 2 Of The Provider |
SUITE 160 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722055405 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
3267 |
Number Of Medicare Beneficiaries |
1380 |
Total Submitted Charge Amount |
337775.52 |
Total Medicare Allowed Amount |
112503.36 |
Total Medicare Payment Amount |
86768.43 |
Total Medicare Standardized Payment Amount |
73828.17 |
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 |
26 |
Number Of Medical Services |
3267 |
Number Of Medicare Beneficiaries With Medical Services |
1380 |
Total Medical Submitted Charge Amount |
337775.52 |
Total Medical Medicare Allowed Amount |
112503.36 |
Total Medical Medicare Payment Amount |
86768.43 |
Total Medical Medicare Standardized Payment Amount |
73828.17 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
261 |
Number Of Beneficiaries Age 65 to 74 |
554 |
Number Of Beneficiaries Age 75 to 84 |
434 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
757 |
Number Of Male Beneficiaries |
623 |
Number Of Non Hispanic White Beneficiaries |
1179 |
Number Of Black or African American Beneficiaries |
175 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1056 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
324 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4578 |