National Provider Identifier [NPI]: |
1356393219 |
Last Name Of The Provider |
OLIVER |
First Name Of The Provider |
RANDALL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 PROFESSIONAL BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVANSVILLE |
Zip Code Of The Provider |
477148016 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
3581 |
Number Of Medicare Beneficiaries |
454 |
Total Submitted Charge Amount |
878987.41 |
Total Medicare Allowed Amount |
398164.92 |
Total Medicare Payment Amount |
283690.73 |
Total Medicare Standardized Payment Amount |
265622.91 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
273 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
264 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
422 |
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 |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
223 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3307 |