National Provider Identifier [NPI]: |
1164576245 |
Last Name Of The Provider |
TRACY |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1111 DUFF AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMES |
Zip Code Of The Provider |
500105793 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1964 |
Number Of Medicare Beneficiaries |
715 |
Total Submitted Charge Amount |
333772 |
Total Medicare Allowed Amount |
188272.54 |
Total Medicare Payment Amount |
146981.97 |
Total Medicare Standardized Payment Amount |
155605.3 |
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 |
29 |
Number Of Medical Services |
1964 |
Number Of Medicare Beneficiaries With Medical Services |
715 |
Total Medical Submitted Charge Amount |
333772 |
Total Medical Medicare Allowed Amount |
188272.54 |
Total Medical Medicare Payment Amount |
146981.97 |
Total Medical Medicare Standardized Payment Amount |
155605.3 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
191 |
Number Of Female Beneficiaries |
400 |
Number Of Male Beneficiaries |
315 |
Number Of Non Hispanic White Beneficiaries |
689 |
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 |
577 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.781 |