National Provider Identifier [NPI]: |
1487656971 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
2881 |
Number Of Medicare Beneficiaries |
433 |
Total Submitted Charge Amount |
959296 |
Total Medicare Allowed Amount |
203401.65 |
Total Medicare Payment Amount |
155049.82 |
Total Medicare Standardized Payment Amount |
155470.42 |
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 |
36 |
Number Of Medical Services |
2881 |
Number Of Medicare Beneficiaries With Medical Services |
433 |
Total Medical Submitted Charge Amount |
959296 |
Total Medical Medicare Allowed Amount |
203401.65 |
Total Medical Medicare Payment Amount |
155049.82 |
Total Medical Medicare Standardized Payment Amount |
155470.42 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
414 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
45 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5324 |