National Provider Identifier [NPI]: |
1235137845 |
Last Name Of The Provider |
HARVEY |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1221 PLEASANT ST |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
DES MOINES |
Zip Code Of The Provider |
503091423 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1482 |
Number Of Medicare Beneficiaries |
249 |
Total Submitted Charge Amount |
211621 |
Total Medicare Allowed Amount |
91332.33 |
Total Medicare Payment Amount |
70545.32 |
Total Medicare Standardized Payment Amount |
75815.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
1579 |
Total Drug Medicare AllowedAmount |
897.11 |
Total Drug Medicare PaymentAmount |
879.15 |
Total Drug Medicare Standardized Payment Amount |
879.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1467 |
Number Of Medicare Beneficiaries With Medical Services |
249 |
Total Medical Submitted Charge Amount |
210042 |
Total Medical Medicare Allowed Amount |
90435.22 |
Total Medical Medicare Payment Amount |
69666.17 |
Total Medical Medicare Standardized Payment Amount |
74936.32 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
224 |
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.7411 |