National Provider Identifier [NPI]: |
1235131723 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
ERIK |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
115 W 12TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAMAR |
Zip Code Of The Provider |
647591756 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
3594 |
Number Of Medicare Beneficiaries |
368 |
Total Submitted Charge Amount |
393177 |
Total Medicare Allowed Amount |
216846.57 |
Total Medicare Payment Amount |
155077.68 |
Total Medicare Standardized Payment Amount |
172861.26 |
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 |
71 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
216 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
357 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2552 |