National Provider Identifier [NPI]: |
1144294992 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
614 NORTHTOWN |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOUNTAIN HOME |
Zip Code Of The Provider |
726533105 |
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 |
131 |
Number Of Services |
17761 |
Number Of Medicare Beneficiaries |
1036 |
Total Submitted Charge Amount |
1024825.6 |
Total Medicare Allowed Amount |
518139.76 |
Total Medicare Payment Amount |
388670.77 |
Total Medicare Standardized Payment Amount |
420026.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
1908 |
Number Of Medicare Beneficiaries With Drug Services |
350 |
Total Drug Submitted ChargeAmount |
44231.6 |
Total Drug Medicare AllowedAmount |
29909.19 |
Total Drug Medicare PaymentAmount |
24676.29 |
Total Drug Medicare Standardized Payment Amount |
24676.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
15853 |
Number Of Medicare Beneficiaries With Medical Services |
1036 |
Total Medical Submitted Charge Amount |
980594 |
Total Medical Medicare Allowed Amount |
488230.57 |
Total Medical Medicare Payment Amount |
363994.48 |
Total Medical Medicare Standardized Payment Amount |
395349.97 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
402 |
Number Of Beneficiaries Age 75 to 84 |
402 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
572 |
Number Of Male Beneficiaries |
464 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
934 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0125 |