National Provider Identifier [NPI]: |
1083725386 |
Last Name Of The Provider |
ROUNSBORG |
First Name Of The Provider |
TERRY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
555 S 70TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685102462 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1376 |
Number Of Medicare Beneficiaries |
1158 |
Total Submitted Charge Amount |
381188 |
Total Medicare Allowed Amount |
180484.8 |
Total Medicare Payment Amount |
131563.72 |
Total Medicare Standardized Payment Amount |
140581.85 |
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 |
27 |
Number Of Medical Services |
1376 |
Number Of Medicare Beneficiaries With Medical Services |
1158 |
Total Medical Submitted Charge Amount |
381188 |
Total Medical Medicare Allowed Amount |
180484.8 |
Total Medical Medicare Payment Amount |
131563.72 |
Total Medical Medicare Standardized Payment Amount |
140581.85 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
329 |
Number Of Beneficiaries Age 75 to 84 |
364 |
Number Of Beneficiaries Age Greater 84 |
301 |
Number Of Female Beneficiaries |
683 |
Number Of Male Beneficiaries |
475 |
Number Of Non Hispanic White Beneficiaries |
1093 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
11 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
899 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
259 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6946 |