National Provider Identifier [NPI]: |
1700172145 |
Last Name Of The Provider |
ORJI |
First Name Of The Provider |
CHRISTIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1423 N JEFFERSON AVE |
Street Address 2 Of The Provider |
B100 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658021917 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
345 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
28415 |
Total Medicare Allowed Amount |
16016.3 |
Total Medicare Payment Amount |
12249.46 |
Total Medicare Standardized Payment Amount |
13270.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
37 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
778 |
Total Drug Medicare AllowedAmount |
697.36 |
Total Drug Medicare PaymentAmount |
683.35 |
Total Drug Medicare Standardized Payment Amount |
683.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
308 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
27637 |
Total Medical Medicare Allowed Amount |
15318.94 |
Total Medical Medicare Payment Amount |
11566.11 |
Total Medical Medicare Standardized Payment Amount |
12586.84 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
164 |
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 |
56 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3878 |