National Provider Identifier [NPI]: |
1043444342 |
Last Name Of The Provider |
SCHNURR |
First Name Of The Provider |
XIMENA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2630 HIGHWAY K |
Street Address 2 Of The Provider |
|
City Of The Provider |
O FALLON |
Zip Code Of The Provider |
633686624 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
387 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
51073.5 |
Total Medicare Allowed Amount |
30056.54 |
Total Medicare Payment Amount |
22187.13 |
Total Medicare Standardized Payment Amount |
22187.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1204.5 |
Total Drug Medicare AllowedAmount |
816.04 |
Total Drug Medicare PaymentAmount |
794.55 |
Total Drug Medicare Standardized Payment Amount |
794.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
346 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
49869 |
Total Medical Medicare Allowed Amount |
29240.5 |
Total Medical Medicare Payment Amount |
21392.58 |
Total Medical Medicare Standardized Payment Amount |
21392.72 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
109 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1856 |