National Provider Identifier [NPI]: |
1578555223 |
Last Name Of The Provider |
ROBEY |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4524 N MARYVALE PKWY |
Street Address 2 Of The Provider |
STE 220 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850311730 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
194 |
Number Of Medicare Beneficiaries |
53 |
Total Submitted Charge Amount |
19040 |
Total Medicare Allowed Amount |
13024.39 |
Total Medicare Payment Amount |
8016.12 |
Total Medicare Standardized Payment Amount |
8810.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
2249 |
Total Drug Medicare AllowedAmount |
1487.92 |
Total Drug Medicare PaymentAmount |
1457.3 |
Total Drug Medicare Standardized Payment Amount |
1457.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
172 |
Number Of Medicare Beneficiaries With Medical Services |
53 |
Total Medical Submitted Charge Amount |
16791 |
Total Medical Medicare Allowed Amount |
11536.47 |
Total Medical Medicare Payment Amount |
6558.82 |
Total Medical Medicare Standardized Payment Amount |
7353.59 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
26 |
Number Of Male Beneficiaries |
27 |
Number Of Non Hispanic White Beneficiaries |
41 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1596 |