National Provider Identifier [NPI]: |
1295927473 |
Last Name Of The Provider |
DAVIES |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1235 E CHEROKEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042203 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
132 |
Number Of Services |
5872 |
Number Of Medicare Beneficiaries |
4171 |
Total Submitted Charge Amount |
1030577 |
Total Medicare Allowed Amount |
200679.24 |
Total Medicare Payment Amount |
151171.6 |
Total Medicare Standardized Payment Amount |
159290.87 |
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 |
132 |
Number Of Medical Services |
5872 |
Number Of Medicare Beneficiaries With Medical Services |
4171 |
Total Medical Submitted Charge Amount |
1030577 |
Total Medical Medicare Allowed Amount |
200679.24 |
Total Medical Medicare Payment Amount |
151171.6 |
Total Medical Medicare Standardized Payment Amount |
159290.87 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
968 |
Number Of Beneficiaries Age 65 to 74 |
1499 |
Number Of Beneficiaries Age 75 to 84 |
1142 |
Number Of Beneficiaries Age Greater 84 |
562 |
Number Of Female Beneficiaries |
2336 |
Number Of Male Beneficiaries |
1835 |
Number Of Non Hispanic White Beneficiaries |
4019 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
35 |
Number Of Beneficiaries With Medicare Only Entitlement |
3140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1031 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5513 |