National Provider Identifier [NPI]: |
1720038227 |
Last Name Of The Provider |
HOLMES |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4321 WASHINGTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641115961 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
10675 |
Number Of Medicare Beneficiaries |
1268 |
Total Submitted Charge Amount |
980210.64 |
Total Medicare Allowed Amount |
434644.54 |
Total Medicare Payment Amount |
322882.1 |
Total Medicare Standardized Payment Amount |
338354.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
5175 |
Number Of Medicare Beneficiaries With Drug Services |
92 |
Total Drug Submitted ChargeAmount |
211801.64 |
Total Drug Medicare AllowedAmount |
79618.17 |
Total Drug Medicare PaymentAmount |
61983.28 |
Total Drug Medicare Standardized Payment Amount |
61983.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
5500 |
Number Of Medicare Beneficiaries With Medical Services |
1268 |
Total Medical Submitted Charge Amount |
768409 |
Total Medical Medicare Allowed Amount |
355026.37 |
Total Medical Medicare Payment Amount |
260898.82 |
Total Medical Medicare Standardized Payment Amount |
276371.62 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
552 |
Number Of Beneficiaries Age 75 to 84 |
407 |
Number Of Beneficiaries Age Greater 84 |
183 |
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
956 |
Number Of Non Hispanic White Beneficiaries |
1120 |
Number Of Black or African American Beneficiaries |
90 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
27 |
Number Of Beneficiaries With Medicare Only Entitlement |
1176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2889 |