National Provider Identifier [NPI]: |
1023119138 |
Last Name Of The Provider |
CARROL |
First Name Of The Provider |
CLIFFORD |
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 |
5915 S RAINBOW BLVD |
Street Address 2 Of The Provider |
SUITE #105 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891182557 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
896 |
Number Of Medicare Beneficiaries |
422 |
Total Submitted Charge Amount |
404941 |
Total Medicare Allowed Amount |
138687.41 |
Total Medicare Payment Amount |
105437.41 |
Total Medicare Standardized Payment Amount |
103544.28 |
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 |
36 |
Number Of Medical Services |
896 |
Number Of Medicare Beneficiaries With Medical Services |
422 |
Total Medical Submitted Charge Amount |
404941 |
Total Medical Medicare Allowed Amount |
138687.41 |
Total Medical Medicare Payment Amount |
105437.41 |
Total Medical Medicare Standardized Payment Amount |
103544.28 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
303 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
319 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9326 |