National Provider Identifier [NPI]: |
1154304301 |
Last Name Of The Provider |
WOODRUFF |
First Name Of The Provider |
LISSA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3219 CENTRAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
KEARNEY |
Zip Code Of The Provider |
688472949 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1350 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
197792 |
Total Medicare Allowed Amount |
98348.7 |
Total Medicare Payment Amount |
75578.23 |
Total Medicare Standardized Payment Amount |
82591.94 |
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 |
21 |
Number Of Medical Services |
1350 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
197792 |
Total Medical Medicare Allowed Amount |
98348.7 |
Total Medical Medicare Payment Amount |
75578.23 |
Total Medical Medicare Standardized Payment Amount |
82591.94 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
159 |
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 |
263 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.782 |