National Provider Identifier [NPI]: |
1780670463 |
Last Name Of The Provider |
ALEXANDER |
First Name Of The Provider |
SAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1423 N JEFFERSON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658021917 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
454 |
Number Of Medicare Beneficiaries |
409 |
Total Submitted Charge Amount |
185862.58 |
Total Medicare Allowed Amount |
56947.49 |
Total Medicare Payment Amount |
44093.25 |
Total Medicare Standardized Payment Amount |
45578.87 |
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 |
26 |
Number Of Medical Services |
454 |
Number Of Medicare Beneficiaries With Medical Services |
409 |
Total Medical Submitted Charge Amount |
185862.58 |
Total Medical Medicare Allowed Amount |
56947.49 |
Total Medical Medicare Payment Amount |
44093.25 |
Total Medical Medicare Standardized Payment Amount |
45578.87 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
386 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
270 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8834 |