National Provider Identifier [NPI]: |
1578536017 |
Last Name Of The Provider |
RILEY |
First Name Of The Provider |
CARA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 MERCY WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLA VISTA |
Zip Code Of The Provider |
727143000 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
6663 |
Number Of Medicare Beneficiaries |
416 |
Total Submitted Charge Amount |
421834 |
Total Medicare Allowed Amount |
188766.09 |
Total Medicare Payment Amount |
149564.75 |
Total Medicare Standardized Payment Amount |
159646.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
1397 |
Number Of Medicare Beneficiaries With Drug Services |
181 |
Total Drug Submitted ChargeAmount |
31715 |
Total Drug Medicare AllowedAmount |
20547.71 |
Total Drug Medicare PaymentAmount |
17736.78 |
Total Drug Medicare Standardized Payment Amount |
17736.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
5266 |
Number Of Medicare Beneficiaries With Medical Services |
416 |
Total Medical Submitted Charge Amount |
390119 |
Total Medical Medicare Allowed Amount |
168218.38 |
Total Medical Medicare Payment Amount |
131827.97 |
Total Medical Medicare Standardized Payment Amount |
141909.7 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
114 |
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 |
377 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0231 |