National Provider Identifier [NPI]: |
1548440522 |
Last Name Of The Provider |
GLOVER |
First Name Of The Provider |
FORREST |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10100 KANIS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722056202 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
3769 |
Number Of Medicare Beneficiaries |
1707 |
Total Submitted Charge Amount |
685195.38 |
Total Medicare Allowed Amount |
301441.05 |
Total Medicare Payment Amount |
225721.86 |
Total Medicare Standardized Payment Amount |
247933.3 |
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 |
87 |
Number Of Medical Services |
3769 |
Number Of Medicare Beneficiaries With Medical Services |
1707 |
Total Medical Submitted Charge Amount |
685195.38 |
Total Medical Medicare Allowed Amount |
301441.05 |
Total Medical Medicare Payment Amount |
225721.86 |
Total Medical Medicare Standardized Payment Amount |
247933.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
211 |
Number Of Beneficiaries Age 65 to 74 |
675 |
Number Of Beneficiaries Age 75 to 84 |
572 |
Number Of Beneficiaries Age Greater 84 |
249 |
Number Of Female Beneficiaries |
837 |
Number Of Male Beneficiaries |
870 |
Number Of Non Hispanic White Beneficiaries |
1537 |
Number Of Black or African American Beneficiaries |
145 |
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 |
1456 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
251 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.4757 |