National Provider Identifier [NPI]: |
1467520346 |
Last Name Of The Provider |
THOMPSON |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2115 S FREMONT AVE |
Street Address 2 Of The Provider |
SUITE 3300 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042239 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1247 |
Number Of Medicare Beneficiaries |
781 |
Total Submitted Charge Amount |
921888 |
Total Medicare Allowed Amount |
187972.95 |
Total Medicare Payment Amount |
145126.66 |
Total Medicare Standardized Payment Amount |
155591.28 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
152 |
Number Of Beneficiaries Age 65 to 74 |
346 |
Number Of Beneficiaries Age 75 to 84 |
228 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
424 |
Number Of Male Beneficiaries |
357 |
Number Of Non Hispanic White Beneficiaries |
756 |
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 |
635 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4349 |