National Provider Identifier [NPI]: |
1578600946 |
Last Name Of The Provider |
HALTER |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1235 E CHEROKEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042203 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
568 |
Number Of Medicare Beneficiaries |
537 |
Total Submitted Charge Amount |
366747 |
Total Medicare Allowed Amount |
70978.19 |
Total Medicare Payment Amount |
54777.37 |
Total Medicare Standardized Payment Amount |
56218.06 |
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 |
88 |
Number Of Medical Services |
568 |
Number Of Medicare Beneficiaries With Medical Services |
537 |
Total Medical Submitted Charge Amount |
366747 |
Total Medical Medicare Allowed Amount |
70978.19 |
Total Medical Medicare Payment Amount |
54777.37 |
Total Medical Medicare Standardized Payment Amount |
56218.06 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
518 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
424 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3633 |