National Provider Identifier [NPI]: |
1235138744 |
Last Name Of The Provider |
SCOTT |
First Name Of The Provider |
RANDALL |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
930 N. SWITZER CANYON DR. |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
FLAGSTAFF |
Zip Code Of The Provider |
86001 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
5207 |
Number Of Medicare Beneficiaries |
619 |
Total Submitted Charge Amount |
469581.5 |
Total Medicare Allowed Amount |
378113.56 |
Total Medicare Payment Amount |
290755.54 |
Total Medicare Standardized Payment Amount |
293211.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
2233 |
Number Of Medicare Beneficiaries With Drug Services |
293 |
Total Drug Submitted ChargeAmount |
57851.5 |
Total Drug Medicare AllowedAmount |
45991.73 |
Total Drug Medicare PaymentAmount |
39694.67 |
Total Drug Medicare Standardized Payment Amount |
39694.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2974 |
Number Of Medicare Beneficiaries With Medical Services |
619 |
Total Medical Submitted Charge Amount |
411730 |
Total Medical Medicare Allowed Amount |
332121.83 |
Total Medical Medicare Payment Amount |
251060.87 |
Total Medical Medicare Standardized Payment Amount |
253516.43 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
376 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
547 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
576 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9132 |