National Provider Identifier [NPI]: |
1649361874 |
Last Name Of The Provider |
PENDLETON |
First Name Of The Provider |
GUS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
736 S 900 E |
Street Address 2 Of The Provider |
#203 |
City Of The Provider |
ST GEORGE |
Zip Code Of The Provider |
847907000 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
125 |
Number Of Services |
7862 |
Number Of Medicare Beneficiaries |
659 |
Total Submitted Charge Amount |
405780 |
Total Medicare Allowed Amount |
237686.07 |
Total Medicare Payment Amount |
182168.97 |
Total Medicare Standardized Payment Amount |
190940.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
1497 |
Number Of Medicare Beneficiaries With Drug Services |
318 |
Total Drug Submitted ChargeAmount |
53506 |
Total Drug Medicare AllowedAmount |
35717.83 |
Total Drug Medicare PaymentAmount |
32229.24 |
Total Drug Medicare Standardized Payment Amount |
32229.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
109 |
Number Of Medical Services |
6365 |
Number Of Medicare Beneficiaries With Medical Services |
659 |
Total Medical Submitted Charge Amount |
352274 |
Total Medical Medicare Allowed Amount |
201968.24 |
Total Medical Medicare Payment Amount |
149939.73 |
Total Medical Medicare Standardized Payment Amount |
158711.12 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
294 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
351 |
Number Of Male Beneficiaries |
308 |
Number Of Non Hispanic White Beneficiaries |
627 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
629 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9506 |