National Provider Identifier [NPI]: |
1740267830 |
Last Name Of The Provider |
ROLLER |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 E BROADWAY |
Street Address 2 Of The Provider |
STE 245 |
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
652018020 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
4241 |
Number Of Medicare Beneficiaries |
1325 |
Total Submitted Charge Amount |
240567.51 |
Total Medicare Allowed Amount |
230983.71 |
Total Medicare Payment Amount |
155836.36 |
Total Medicare Standardized Payment Amount |
175488.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
108.89 |
Total Drug Medicare AllowedAmount |
94.8 |
Total Drug Medicare PaymentAmount |
66.39 |
Total Drug Medicare Standardized Payment Amount |
66.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
4184 |
Number Of Medicare Beneficiaries With Medical Services |
1325 |
Total Medical Submitted Charge Amount |
240458.62 |
Total Medical Medicare Allowed Amount |
230888.91 |
Total Medical Medicare Payment Amount |
155769.97 |
Total Medical Medicare Standardized Payment Amount |
175422.26 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
550 |
Number Of Beneficiaries Age 75 to 84 |
503 |
Number Of Beneficiaries Age Greater 84 |
222 |
Number Of Female Beneficiaries |
626 |
Number Of Male Beneficiaries |
699 |
Number Of Non Hispanic White Beneficiaries |
1291 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.955 |