National Provider Identifier [NPI]: |
1043395668 |
Last Name Of The Provider |
ROGERS |
First Name Of The Provider |
LARRY |
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 |
7 MEMORIAL DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PETERSBURG |
Zip Code Of The Provider |
268470007 |
State Code Of The Provider |
WV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
494 |
Number Of Medicare Beneficiaries |
163 |
Total Submitted Charge Amount |
28995 |
Total Medicare Allowed Amount |
28497.95 |
Total Medicare Payment Amount |
16879.87 |
Total Medicare Standardized Payment Amount |
24553.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
270 |
Total Drug Medicare AllowedAmount |
248.84 |
Total Drug Medicare PaymentAmount |
164.89 |
Total Drug Medicare Standardized Payment Amount |
164.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
476 |
Number Of Medicare Beneficiaries With Medical Services |
163 |
Total Medical Submitted Charge Amount |
28725 |
Total Medical Medicare Allowed Amount |
28249.11 |
Total Medical Medicare Payment Amount |
16714.98 |
Total Medical Medicare Standardized Payment Amount |
24388.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
163 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
116 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
|
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8667 |