National Provider Identifier [NPI]: |
1972569366 |
Last Name Of The Provider |
DOLLINS |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
324 N 2ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROGERS |
Zip Code Of The Provider |
727566647 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
1222 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
108130.18 |
Total Medicare Allowed Amount |
73942.02 |
Total Medicare Payment Amount |
54597.01 |
Total Medicare Standardized Payment Amount |
60429.53 |
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 |
6 |
Number Of Medical Services |
1222 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
108130.18 |
Total Medical Medicare Allowed Amount |
73942.02 |
Total Medical Medicare Payment Amount |
54597.01 |
Total Medical Medicare Standardized Payment Amount |
60429.53 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
320 |
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 |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
3 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
33 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3974 |