National Provider Identifier [NPI]: |
1437240520 |
Last Name Of The Provider |
ROSEN |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1423 N JEFFERSON AVE |
Street Address 2 Of The Provider |
SUITE K100 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658021917 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1705 |
Number Of Medicare Beneficiaries |
601 |
Total Submitted Charge Amount |
227085 |
Total Medicare Allowed Amount |
138256.09 |
Total Medicare Payment Amount |
93231.13 |
Total Medicare Standardized Payment Amount |
98855.67 |
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 |
19 |
Number Of Medical Services |
1705 |
Number Of Medicare Beneficiaries With Medical Services |
601 |
Total Medical Submitted Charge Amount |
227085 |
Total Medical Medicare Allowed Amount |
138256.09 |
Total Medical Medicare Payment Amount |
93231.13 |
Total Medical Medicare Standardized Payment Amount |
98855.67 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
209 |
Number Of Female Beneficiaries |
377 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
567 |
Number Of Black or African American Beneficiaries |
22 |
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 |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6095 |