National Provider Identifier [NPI]: |
1285721647 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1911 S NATIONAL AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042219 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
2044 |
Number Of Medicare Beneficiaries |
546 |
Total Submitted Charge Amount |
793302 |
Total Medicare Allowed Amount |
278098.04 |
Total Medicare Payment Amount |
214962.02 |
Total Medicare Standardized Payment Amount |
225712.74 |
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 |
|
Total Drug Medicare PaymentAmount |
|
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 |
70 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
245 |
Number Of Male Beneficiaries |
301 |
Number Of Non Hispanic White Beneficiaries |
516 |
Number Of Black or African American Beneficiaries |
14 |
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 |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.9808 |