National Provider Identifier [NPI]: |
1922095066 |
Last Name Of The Provider |
FIELD |
First Name Of The Provider |
F |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
74 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
90666 |
Total Medicare Allowed Amount |
10303.94 |
Total Medicare Payment Amount |
7886.73 |
Total Medicare Standardized Payment Amount |
8641.39 |
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 |
74 |
Number Of Medicare Beneficiaries With Medical Services |
54 |
Total Medical Submitted Charge Amount |
90666 |
Total Medical Medicare Allowed Amount |
10303.94 |
Total Medical Medicare Payment Amount |
7886.73 |
Total Medical Medicare Standardized Payment Amount |
8641.39 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
22 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
30 |
Number Of Male Beneficiaries |
24 |
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 |
42 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8696 |