National Provider Identifier [NPI]: |
1295700904 |
Last Name Of The Provider |
ECKERT |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1609 W 40TH AVE |
Street Address 2 Of The Provider |
SUITE 403 |
City Of The Provider |
PINE BLUFF |
Zip Code Of The Provider |
716036319 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
135 |
Number Of Services |
672 |
Number Of Medicare Beneficiaries |
257 |
Total Submitted Charge Amount |
383692.25 |
Total Medicare Allowed Amount |
129317.49 |
Total Medicare Payment Amount |
99339.03 |
Total Medicare Standardized Payment Amount |
108313.37 |
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 |
135 |
Number Of Medical Services |
672 |
Number Of Medicare Beneficiaries With Medical Services |
257 |
Total Medical Submitted Charge Amount |
383692.25 |
Total Medical Medicare Allowed Amount |
129317.49 |
Total Medical Medicare Payment Amount |
99339.03 |
Total Medical Medicare Standardized Payment Amount |
108313.37 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
165 |
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 |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6889 |