National Provider Identifier [NPI]: |
1336133750 |
Last Name Of The Provider |
GEORGE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 CLAY EDWARDS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH KANSAS CITY |
Zip Code Of The Provider |
641163220 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
672 |
Number Of Medicare Beneficiaries |
536 |
Total Submitted Charge Amount |
239998 |
Total Medicare Allowed Amount |
84531.94 |
Total Medicare Payment Amount |
62291.09 |
Total Medicare Standardized Payment Amount |
63003.95 |
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 |
19 |
Number Of Medical Services |
672 |
Number Of Medicare Beneficiaries With Medical Services |
536 |
Total Medical Submitted Charge Amount |
239998 |
Total Medical Medicare Allowed Amount |
84531.94 |
Total Medical Medicare Payment Amount |
62291.09 |
Total Medical Medicare Standardized Payment Amount |
63003.95 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
179 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
329 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
470 |
Number Of Black or African American Beneficiaries |
34 |
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 |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.838 |