National Provider Identifier [NPI]: |
1679522528 |
Last Name Of The Provider |
SPRY |
First Name Of The Provider |
LESLIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7441 O ST |
Street Address 2 Of The Provider |
STE 304 |
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685102468 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
5911 |
Number Of Medicare Beneficiaries |
690 |
Total Submitted Charge Amount |
334627.57 |
Total Medicare Allowed Amount |
303652.15 |
Total Medicare Payment Amount |
225712.26 |
Total Medicare Standardized Payment Amount |
239613.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
3100 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
37187.4 |
Total Drug Medicare AllowedAmount |
35501 |
Total Drug Medicare PaymentAmount |
27024.94 |
Total Drug Medicare Standardized Payment Amount |
27024.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2811 |
Number Of Medicare Beneficiaries With Medical Services |
690 |
Total Medical Submitted Charge Amount |
297440.17 |
Total Medical Medicare Allowed Amount |
268151.15 |
Total Medical Medicare Payment Amount |
198687.32 |
Total Medical Medicare Standardized Payment Amount |
212588.51 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
362 |
Number Of Non Hispanic White Beneficiaries |
648 |
Number Of Black or African American Beneficiaries |
19 |
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 |
516 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
3.3287 |