National Provider Identifier [NPI]: |
1215256128 |
Last Name Of The Provider |
WEIR |
First Name Of The Provider |
JESSE |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6911 VAN DORN ST |
Street Address 2 Of The Provider |
SUITE # 2 |
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685066801 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
143 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
98350 |
Total Medicare Allowed Amount |
25214.94 |
Total Medicare Payment Amount |
19768.35 |
Total Medicare Standardized Payment Amount |
21143.37 |
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 |
56 |
Number Of Medical Services |
143 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
98350 |
Total Medical Medicare Allowed Amount |
25214.94 |
Total Medical Medicare Payment Amount |
19768.35 |
Total Medical Medicare Standardized Payment Amount |
21143.37 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
52 |
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 |
81 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4407 |