National Provider Identifier [NPI]: |
1316998503 |
Last Name Of The Provider |
LLORENS |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 SOUTHHAMPTON |
Street Address 2 Of The Provider |
STE 104 |
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
65203 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
936 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
88088 |
Total Medicare Allowed Amount |
55372.81 |
Total Medicare Payment Amount |
43763.66 |
Total Medicare Standardized Payment Amount |
47515.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
72 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
3085 |
Total Drug Medicare AllowedAmount |
2644.88 |
Total Drug Medicare PaymentAmount |
2591.89 |
Total Drug Medicare Standardized Payment Amount |
2591.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
864 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
85003 |
Total Medical Medicare Allowed Amount |
52727.93 |
Total Medical Medicare Payment Amount |
41171.77 |
Total Medical Medicare Standardized Payment Amount |
44923.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
241 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8176 |