National Provider Identifier [NPI]: |
1427004217 |
Last Name Of The Provider |
STANLEY |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 SHADOW LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891064119 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
508 |
Number Of Medicare Beneficiaries |
399 |
Total Submitted Charge Amount |
577362 |
Total Medicare Allowed Amount |
70329.28 |
Total Medicare Payment Amount |
53307.91 |
Total Medicare Standardized Payment Amount |
52613.22 |
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 |
16 |
Number Of Medical Services |
508 |
Number Of Medicare Beneficiaries With Medical Services |
399 |
Total Medical Submitted Charge Amount |
577362 |
Total Medical Medicare Allowed Amount |
70329.28 |
Total Medical Medicare Payment Amount |
53307.91 |
Total Medical Medicare Standardized Payment Amount |
52613.22 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2583 |