National Provider Identifier [NPI]: |
1861454910 |
Last Name Of The Provider |
GREGORY |
First Name Of The Provider |
REUEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2305 SOUTH 65 HIGHWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARSHALL |
Zip Code Of The Provider |
653403702 |
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 |
17 |
Number Of Services |
659 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
238248 |
Total Medicare Allowed Amount |
67039.66 |
Total Medicare Payment Amount |
48049.05 |
Total Medicare Standardized Payment Amount |
49884.69 |
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 |
17 |
Number Of Medical Services |
659 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
238248 |
Total Medical Medicare Allowed Amount |
67039.66 |
Total Medical Medicare Payment Amount |
48049.05 |
Total Medical Medicare Standardized Payment Amount |
49884.69 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
150 |
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 |
245 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4909 |