National Provider Identifier [NPI]: |
1205010022 |
Last Name Of The Provider |
WINSTON |
First Name Of The Provider |
RACHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2828 N NATIONAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658034306 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
497 |
Number Of Medicare Beneficiaries |
478 |
Total Submitted Charge Amount |
73296.84 |
Total Medicare Allowed Amount |
41910.39 |
Total Medicare Payment Amount |
28091.13 |
Total Medicare Standardized Payment Amount |
31616.55 |
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 |
18 |
Number Of Medical Services |
497 |
Number Of Medicare Beneficiaries With Medical Services |
478 |
Total Medical Submitted Charge Amount |
73296.84 |
Total Medical Medicare Allowed Amount |
41910.39 |
Total Medical Medicare Payment Amount |
28091.13 |
Total Medical Medicare Standardized Payment Amount |
31616.55 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
461 |
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 |
353 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.147 |