National Provider Identifier [NPI]: |
1013958008 |
Last Name Of The Provider |
ESTES |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
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 |
104 |
Number Of Services |
4833 |
Number Of Medicare Beneficiaries |
650 |
Total Submitted Charge Amount |
420582 |
Total Medicare Allowed Amount |
191353.25 |
Total Medicare Payment Amount |
152988.52 |
Total Medicare Standardized Payment Amount |
165275.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
868 |
Number Of Medicare Beneficiaries With Drug Services |
195 |
Total Drug Submitted ChargeAmount |
23731 |
Total Drug Medicare AllowedAmount |
15362.19 |
Total Drug Medicare PaymentAmount |
14054.95 |
Total Drug Medicare Standardized Payment Amount |
14054.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
3965 |
Number Of Medicare Beneficiaries With Medical Services |
649 |
Total Medical Submitted Charge Amount |
396851 |
Total Medical Medicare Allowed Amount |
175991.06 |
Total Medical Medicare Payment Amount |
138933.57 |
Total Medical Medicare Standardized Payment Amount |
151220.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
268 |
Number Of Beneficiaries Age 75 to 84 |
222 |
Number Of Beneficiaries Age Greater 84 |
112 |
Number Of Female Beneficiaries |
325 |
Number Of Male Beneficiaries |
325 |
Number Of Non Hispanic White Beneficiaries |
627 |
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 |
601 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9996 |