National Provider Identifier [NPI]: |
1518006170 |
Last Name Of The Provider |
ALUMNO |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3231 S NATIONAL AVE |
Street Address 2 Of The Provider |
SUITE 140 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658077304 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
3098 |
Number Of Medicare Beneficiaries |
593 |
Total Submitted Charge Amount |
398397.5 |
Total Medicare Allowed Amount |
276324.69 |
Total Medicare Payment Amount |
201080.95 |
Total Medicare Standardized Payment Amount |
214564.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
94 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
4869 |
Total Drug Medicare AllowedAmount |
3391.75 |
Total Drug Medicare PaymentAmount |
3301.44 |
Total Drug Medicare Standardized Payment Amount |
3301.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
3004 |
Number Of Medicare Beneficiaries With Medical Services |
593 |
Total Medical Submitted Charge Amount |
393528.5 |
Total Medical Medicare Allowed Amount |
272932.94 |
Total Medical Medicare Payment Amount |
197779.51 |
Total Medical Medicare Standardized Payment Amount |
211262.93 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
187 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
563 |
Number Of Black or African American Beneficiaries |
14 |
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 |
412 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
181 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.689 |