National Provider Identifier [NPI]: |
1669554465 |
Last Name Of The Provider |
ROBERTS |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2316 E MEYER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641321136 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
152 |
Number Of Medicare Beneficiaries |
135 |
Total Submitted Charge Amount |
113430 |
Total Medicare Allowed Amount |
14551.25 |
Total Medicare Payment Amount |
10788.96 |
Total Medicare Standardized Payment Amount |
12817.63 |
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 |
12 |
Number Of Medical Services |
152 |
Number Of Medicare Beneficiaries With Medical Services |
135 |
Total Medical Submitted Charge Amount |
113430 |
Total Medical Medicare Allowed Amount |
14551.25 |
Total Medical Medicare Payment Amount |
10788.96 |
Total Medical Medicare Standardized Payment Amount |
12817.63 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
101 |
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 |
54 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7162 |