National Provider Identifier [NPI]: |
1063479103 |
Last Name Of The Provider |
ROLAN |
First Name Of The Provider |
TERRY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 HOSPITAL DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
652120001 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
526 |
Number Of Medicare Beneficiaries |
310 |
Total Submitted Charge Amount |
96410 |
Total Medicare Allowed Amount |
40939.39 |
Total Medicare Payment Amount |
28289.49 |
Total Medicare Standardized Payment Amount |
29804.84 |
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 |
25 |
Number Of Medical Services |
526 |
Number Of Medicare Beneficiaries With Medical Services |
310 |
Total Medical Submitted Charge Amount |
96410 |
Total Medical Medicare Allowed Amount |
40939.39 |
Total Medical Medicare Payment Amount |
28289.49 |
Total Medical Medicare Standardized Payment Amount |
29804.84 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
281 |
Number Of Black or African American Beneficiaries |
18 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.5056 |