National Provider Identifier [NPI]: |
1275562951 |
Last Name Of The Provider |
LLANA |
First Name Of The Provider |
ANGELO |
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 |
5325 FARAON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT JOSEPH |
Zip Code Of The Provider |
645063488 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
932 |
Number Of Medicare Beneficiaries |
652 |
Total Submitted Charge Amount |
180052 |
Total Medicare Allowed Amount |
100386.61 |
Total Medicare Payment Amount |
76188.22 |
Total Medicare Standardized Payment Amount |
80605.8 |
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 |
28 |
Number Of Medical Services |
932 |
Number Of Medicare Beneficiaries With Medical Services |
652 |
Total Medical Submitted Charge Amount |
180052 |
Total Medical Medicare Allowed Amount |
100386.61 |
Total Medical Medicare Payment Amount |
76188.22 |
Total Medical Medicare Standardized Payment Amount |
80605.8 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
388 |
Number Of Male Beneficiaries |
264 |
Number Of Non Hispanic White Beneficiaries |
625 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
440 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.0286 |