National Provider Identifier [NPI]: |
1871814194 |
Last Name Of The Provider |
FARRELL |
First Name Of The Provider |
ANGELA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
DEPT OF FAMILY MEDICINE |
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421007 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
444 |
Number Of Medicare Beneficiaries |
108 |
Total Submitted Charge Amount |
53058 |
Total Medicare Allowed Amount |
24641.27 |
Total Medicare Payment Amount |
17613.6 |
Total Medicare Standardized Payment Amount |
19224.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
1196 |
Total Drug Medicare AllowedAmount |
882.91 |
Total Drug Medicare PaymentAmount |
864 |
Total Drug Medicare Standardized Payment Amount |
864 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
419 |
Number Of Medicare Beneficiaries With Medical Services |
108 |
Total Medical Submitted Charge Amount |
51862 |
Total Medical Medicare Allowed Amount |
23758.36 |
Total Medical Medicare Payment Amount |
16749.6 |
Total Medical Medicare Standardized Payment Amount |
18360.69 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8778 |