National Provider Identifier [NPI]: |
1548437544 |
Last Name Of The Provider |
GREEN |
First Name Of The Provider |
NORMA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2411 HOLMES ST |
Street Address 2 Of The Provider |
UMKC SCHOOL OF MEDICINE RESIDENTCY PROGRAM M2-302 |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641082792 |
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 |
19 |
Number Of Services |
128 |
Number Of Medicare Beneficiaries |
61 |
Total Submitted Charge Amount |
21406 |
Total Medicare Allowed Amount |
12836.19 |
Total Medicare Payment Amount |
9449.77 |
Total Medicare Standardized Payment Amount |
9932.63 |
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 |
19 |
Number Of Medical Services |
128 |
Number Of Medicare Beneficiaries With Medical Services |
61 |
Total Medical Submitted Charge Amount |
21406 |
Total Medical Medicare Allowed Amount |
12836.19 |
Total Medical Medicare Payment Amount |
9449.77 |
Total Medical Medicare Standardized Payment Amount |
9932.63 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
13 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
21 |
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 |
45 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.24 |