National Provider Identifier [NPI]: |
1295891455 |
Last Name Of The Provider |
REINBOLD |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3231 S NATIONAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658077304 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1964 |
Number Of Medicare Beneficiaries |
362 |
Total Submitted Charge Amount |
201957 |
Total Medicare Allowed Amount |
132492.47 |
Total Medicare Payment Amount |
101805.91 |
Total Medicare Standardized Payment Amount |
110142.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
430 |
Number Of Medicare Beneficiaries With Drug Services |
180 |
Total Drug Submitted ChargeAmount |
32394 |
Total Drug Medicare AllowedAmount |
21703.16 |
Total Drug Medicare PaymentAmount |
20676 |
Total Drug Medicare Standardized Payment Amount |
20676 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1534 |
Number Of Medicare Beneficiaries With Medical Services |
362 |
Total Medical Submitted Charge Amount |
169563 |
Total Medical Medicare Allowed Amount |
110789.31 |
Total Medical Medicare Payment Amount |
81129.91 |
Total Medical Medicare Standardized Payment Amount |
89466.31 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
330 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2694 |