National Provider Identifier [NPI]: |
1184708612 |
Last Name Of The Provider |
STECK |
First Name Of The Provider |
LARA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
652120001 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
258 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
79296 |
Total Medicare Allowed Amount |
24986.08 |
Total Medicare Payment Amount |
19181.34 |
Total Medicare Standardized Payment Amount |
23397.98 |
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 |
15 |
Number Of Medical Services |
258 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
79296 |
Total Medical Medicare Allowed Amount |
24986.08 |
Total Medical Medicare Payment Amount |
19181.34 |
Total Medical Medicare Standardized Payment Amount |
23397.98 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
134 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
186 |
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 |
105 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
59 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.848 |