National Provider Identifier [NPI]: |
1154383636 |
Last Name Of The Provider |
MUKUNYADZI |
First Name Of The Provider |
PERKINS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 SAINT VINCENT CIR |
Street Address 2 Of The Provider |
SUITE 160 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722055405 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
3682 |
Number Of Medicare Beneficiaries |
1403 |
Total Submitted Charge Amount |
374525.8 |
Total Medicare Allowed Amount |
116015.28 |
Total Medicare Payment Amount |
89597.88 |
Total Medicare Standardized Payment Amount |
76589.29 |
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 |
3682 |
Number Of Medicare Beneficiaries With Medical Services |
1403 |
Total Medical Submitted Charge Amount |
374525.8 |
Total Medical Medicare Allowed Amount |
116015.28 |
Total Medical Medicare Payment Amount |
89597.88 |
Total Medical Medicare Standardized Payment Amount |
76589.29 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
250 |
Number Of Beneficiaries Age 65 to 74 |
563 |
Number Of Beneficiaries Age 75 to 84 |
448 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
779 |
Number Of Male Beneficiaries |
624 |
Number Of Non Hispanic White Beneficiaries |
1199 |
Number Of Black or African American Beneficiaries |
178 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
301 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5054 |