National Provider Identifier [NPI]: |
1497700579 |
Last Name Of The Provider |
WARD |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
77 W FOREST AVENUE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
FLAGSTAFF |
Zip Code Of The Provider |
860011482 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
265 |
Number Of Services |
14976 |
Number Of Medicare Beneficiaries |
2561 |
Total Submitted Charge Amount |
1237048.15 |
Total Medicare Allowed Amount |
301151.1 |
Total Medicare Payment Amount |
232480.11 |
Total Medicare Standardized Payment Amount |
237275.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
10345 |
Number Of Medicare Beneficiaries With Drug Services |
178 |
Total Drug Submitted ChargeAmount |
13130.09 |
Total Drug Medicare AllowedAmount |
3849.98 |
Total Drug Medicare PaymentAmount |
2963.6 |
Total Drug Medicare Standardized Payment Amount |
2963.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
256 |
Number Of Medical Services |
4631 |
Number Of Medicare Beneficiaries With Medical Services |
2561 |
Total Medical Submitted Charge Amount |
1223918.06 |
Total Medical Medicare Allowed Amount |
297301.12 |
Total Medical Medicare Payment Amount |
229516.51 |
Total Medical Medicare Standardized Payment Amount |
234311.57 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
367 |
Number Of Beneficiaries Age 65 to 74 |
1159 |
Number Of Beneficiaries Age 75 to 84 |
706 |
Number Of Beneficiaries Age Greater 84 |
329 |
Number Of Female Beneficiaries |
1438 |
Number Of Male Beneficiaries |
1123 |
Number Of Non Hispanic White Beneficiaries |
1747 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
187 |
Number Of American Indian Alaska Native Beneficiaries |
549 |
Number Of Beneficiaries With Race Not Else where Classified |
34 |
Number Of Beneficiaries With Medicare Only Entitlement |
1890 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
671 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4957 |