National Provider Identifier [NPI]: |
1982798591 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
SEAN |
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 |
1221 S GEAR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST BURLINGTON |
Zip Code Of The Provider |
52655 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
247 |
Number Of Medicare Beneficiaries |
237 |
Total Submitted Charge Amount |
219915 |
Total Medicare Allowed Amount |
56159.12 |
Total Medicare Payment Amount |
43442.08 |
Total Medicare Standardized Payment Amount |
46357.97 |
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 |
60 |
Number Of Medical Services |
247 |
Number Of Medicare Beneficiaries With Medical Services |
237 |
Total Medical Submitted Charge Amount |
219915 |
Total Medical Medicare Allowed Amount |
56159.12 |
Total Medical Medicare Payment Amount |
43442.08 |
Total Medical Medicare Standardized Payment Amount |
46357.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4505 |