National Provider Identifier [NPI]: |
1700049194 |
Last Name Of The Provider |
EATON |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1111 6TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DES MOINES |
Zip Code Of The Provider |
503142613 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2352 |
Number Of Medicare Beneficiaries |
711 |
Total Submitted Charge Amount |
267268 |
Total Medicare Allowed Amount |
73619.69 |
Total Medicare Payment Amount |
57546.38 |
Total Medicare Standardized Payment Amount |
45025.67 |
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 |
25 |
Number Of Medical Services |
2352 |
Number Of Medicare Beneficiaries With Medical Services |
711 |
Total Medical Submitted Charge Amount |
267268 |
Total Medical Medicare Allowed Amount |
73619.69 |
Total Medical Medicare Payment Amount |
57546.38 |
Total Medical Medicare Standardized Payment Amount |
45025.67 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
319 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
410 |
Number Of Male Beneficiaries |
301 |
Number Of Non Hispanic White Beneficiaries |
673 |
Number Of Black or African American Beneficiaries |
21 |
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 |
554 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3918 |