National Provider Identifier [NPI]: |
1417964859 |
Last Name Of The Provider |
LUO |
First Name Of The Provider |
CATHY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 E MILLSAP RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FAYETTEVILLE |
Zip Code Of The Provider |
727034098 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
10356 |
Number Of Medicare Beneficiaries |
491 |
Total Submitted Charge Amount |
1836977.85 |
Total Medicare Allowed Amount |
561205.53 |
Total Medicare Payment Amount |
411566.62 |
Total Medicare Standardized Payment Amount |
438227.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
5186 |
Number Of Medicare Beneficiaries With Drug Services |
311 |
Total Drug Submitted ChargeAmount |
345647.99 |
Total Drug Medicare AllowedAmount |
16362.45 |
Total Drug Medicare PaymentAmount |
12006.56 |
Total Drug Medicare Standardized Payment Amount |
12006.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
5170 |
Number Of Medicare Beneficiaries With Medical Services |
491 |
Total Medical Submitted Charge Amount |
1491329.86 |
Total Medical Medicare Allowed Amount |
544843.08 |
Total Medical Medicare Payment Amount |
399560.06 |
Total Medical Medicare Standardized Payment Amount |
426220.63 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
346 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
324 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
456 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3394 |