National Provider Identifier [NPI]: |
1487854840 |
Last Name Of The Provider |
ARENTZ |
First Name Of The Provider |
SUELLEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4301 W MARKHAM ST |
Street Address 2 Of The Provider |
SLOT 725 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722057101 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
517 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
192250 |
Total Medicare Allowed Amount |
78468.21 |
Total Medicare Payment Amount |
60881.75 |
Total Medicare Standardized Payment Amount |
61895.13 |
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 |
57 |
Number Of Medical Services |
517 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
192250 |
Total Medical Medicare Allowed Amount |
78468.21 |
Total Medical Medicare Payment Amount |
60881.75 |
Total Medical Medicare Standardized Payment Amount |
61895.13 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
160 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
41 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4687 |