National Provider Identifier [NPI]: |
1083684583 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 SAINT FRANCIS DR |
Street Address 2 Of The Provider |
SUITE 15 |
City Of The Provider |
CAPE GIRARDEAU |
Zip Code Of The Provider |
637035049 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
4227 |
Number Of Medicare Beneficiaries |
2164 |
Total Submitted Charge Amount |
1003160 |
Total Medicare Allowed Amount |
258032.92 |
Total Medicare Payment Amount |
196221.26 |
Total Medicare Standardized Payment Amount |
206438.7 |
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 |
59 |
Number Of Medical Services |
4227 |
Number Of Medicare Beneficiaries With Medical Services |
2164 |
Total Medical Submitted Charge Amount |
1003160 |
Total Medical Medicare Allowed Amount |
258032.92 |
Total Medical Medicare Payment Amount |
196221.26 |
Total Medical Medicare Standardized Payment Amount |
206438.7 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
396 |
Number Of Beneficiaries Age 65 to 74 |
765 |
Number Of Beneficiaries Age 75 to 84 |
657 |
Number Of Beneficiaries Age Greater 84 |
346 |
Number Of Female Beneficiaries |
1238 |
Number Of Male Beneficiaries |
926 |
Number Of Non Hispanic White Beneficiaries |
2016 |
Number Of Black or African American Beneficiaries |
120 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1542 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
622 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.633 |