National Provider Identifier [NPI]: |
1700842218 |
Last Name Of The Provider |
OVER |
First Name Of The Provider |
DARRELL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4010 S MULBERRY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PINE BLUFF |
Zip Code Of The Provider |
716037000 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
3644 |
Number Of Medicare Beneficiaries |
839 |
Total Submitted Charge Amount |
282996 |
Total Medicare Allowed Amount |
181170.04 |
Total Medicare Payment Amount |
135477.7 |
Total Medicare Standardized Payment Amount |
145830.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
130 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
2011 |
Total Drug Medicare AllowedAmount |
1660.74 |
Total Drug Medicare PaymentAmount |
1620.89 |
Total Drug Medicare Standardized Payment Amount |
1620.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
100 |
Number Of Medical Services |
3514 |
Number Of Medicare Beneficiaries With Medical Services |
838 |
Total Medical Submitted Charge Amount |
280985 |
Total Medical Medicare Allowed Amount |
179509.3 |
Total Medical Medicare Payment Amount |
133856.81 |
Total Medical Medicare Standardized Payment Amount |
144209.12 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
298 |
Number Of Beneficiaries Age 65 to 74 |
231 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
509 |
Number Of Male Beneficiaries |
330 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
457 |
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 |
388 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
451 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.6623 |