National Provider Identifier [NPI]: |
1245222181 |
Last Name Of The Provider |
LARSEN |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10561 JEFFREYS ST |
Street Address 2 Of The Provider |
110 |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890524179 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
2539 |
Number Of Medicare Beneficiaries |
418 |
Total Submitted Charge Amount |
399076.5 |
Total Medicare Allowed Amount |
220350.37 |
Total Medicare Payment Amount |
162281.93 |
Total Medicare Standardized Payment Amount |
159209.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
66 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
982.5 |
Total Drug Medicare AllowedAmount |
87.44 |
Total Drug Medicare PaymentAmount |
62.65 |
Total Drug Medicare Standardized Payment Amount |
62.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
2473 |
Number Of Medicare Beneficiaries With Medical Services |
417 |
Total Medical Submitted Charge Amount |
398094 |
Total Medical Medicare Allowed Amount |
220262.93 |
Total Medical Medicare Payment Amount |
162219.28 |
Total Medical Medicare Standardized Payment Amount |
159146.49 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
228 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
216 |
Number Of Male Beneficiaries |
202 |
Number Of Non Hispanic White Beneficiaries |
353 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
403 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.53 |