National Provider Identifier [NPI]: |
1902875701 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
PAMELA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 SAINT FRANCIS DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CAPE GIRARDEAU |
Zip Code Of The Provider |
63703 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
214 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
101753 |
Total Medicare Allowed Amount |
30254.82 |
Total Medicare Payment Amount |
21556.38 |
Total Medicare Standardized Payment Amount |
23136.98 |
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 |
11 |
Number Of Medical Services |
214 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
101753 |
Total Medical Medicare Allowed Amount |
30254.82 |
Total Medical Medicare Payment Amount |
21556.38 |
Total Medical Medicare Standardized Payment Amount |
23136.98 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
173 |
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 |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2604 |