National Provider Identifier [NPI]: |
1033176250 |
Last Name Of The Provider |
CANADA |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1910 NONCONNAH BLVD |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381322113 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1402 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
409127.02 |
Total Medicare Allowed Amount |
207504.48 |
Total Medicare Payment Amount |
158385.68 |
Total Medicare Standardized Payment Amount |
167016.36 |
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 |
57 |
Number Of Beneficiaries Age Less65 |
197 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
56 |
Number Of Black or African American Beneficiaries |
235 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
60 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
5.5676 |