National Provider Identifier [NPI]: |
1508898248 |
Last Name Of The Provider |
HURD |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8248 S 96TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA VISTA |
Zip Code Of The Provider |
681283126 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
216 |
Number Of Medicare Beneficiaries |
106 |
Total Submitted Charge Amount |
24995 |
Total Medicare Allowed Amount |
12392.2 |
Total Medicare Payment Amount |
8610.93 |
Total Medicare Standardized Payment Amount |
9307.04 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.809 |