National Provider Identifier [NPI]: |
1578538229 |
Last Name Of The Provider |
CLAYBROOK |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 CENTERVIEW DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722114349 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
182 |
Number Of Services |
16227 |
Number Of Medicare Beneficiaries |
1483 |
Total Submitted Charge Amount |
1576341 |
Total Medicare Allowed Amount |
650623.03 |
Total Medicare Payment Amount |
498786.49 |
Total Medicare Standardized Payment Amount |
541212.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
4843 |
Number Of Medicare Beneficiaries With Drug Services |
76 |
Total Drug Submitted ChargeAmount |
141759.2 |
Total Drug Medicare AllowedAmount |
100332.38 |
Total Drug Medicare PaymentAmount |
78265.4 |
Total Drug Medicare Standardized Payment Amount |
78265.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
173 |
Number Of Medical Services |
11384 |
Number Of Medicare Beneficiaries With Medical Services |
1483 |
Total Medical Submitted Charge Amount |
1434581.8 |
Total Medical Medicare Allowed Amount |
550290.65 |
Total Medical Medicare Payment Amount |
420521.09 |
Total Medical Medicare Standardized Payment Amount |
462946.94 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
661 |
Number Of Beneficiaries Age 75 to 84 |
478 |
Number Of Beneficiaries Age Greater 84 |
175 |
Number Of Female Beneficiaries |
418 |
Number Of Male Beneficiaries |
1065 |
Number Of Non Hispanic White Beneficiaries |
1345 |
Number Of Black or African American Beneficiaries |
119 |
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 |
1320 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
163 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1862 |