National Provider Identifier [NPI]: |
1881707750 |
Last Name Of The Provider |
WALDO |
First Name Of The Provider |
LANCE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4401 WORNALL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641113220 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
945 |
Number Of Medicare Beneficiaries |
680 |
Total Submitted Charge Amount |
338881.32 |
Total Medicare Allowed Amount |
100153.04 |
Total Medicare Payment Amount |
75800.14 |
Total Medicare Standardized Payment Amount |
77616.24 |
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 |
23 |
Number Of Medical Services |
945 |
Number Of Medicare Beneficiaries With Medical Services |
680 |
Total Medical Submitted Charge Amount |
338881.32 |
Total Medical Medicare Allowed Amount |
100153.04 |
Total Medical Medicare Payment Amount |
75800.14 |
Total Medical Medicare Standardized Payment Amount |
77616.24 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
202 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
394 |
Number Of Male Beneficiaries |
286 |
Number Of Non Hispanic White Beneficiaries |
608 |
Number Of Black or African American Beneficiaries |
47 |
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 |
588 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4584 |