National Provider Identifier [NPI]: |
1902884513 |
Last Name Of The Provider |
JERDE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10 E 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KEARNEY |
Zip Code Of The Provider |
688472918 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
189 |
Number Of Services |
4796 |
Number Of Medicare Beneficiaries |
2421 |
Total Submitted Charge Amount |
435310 |
Total Medicare Allowed Amount |
148759.71 |
Total Medicare Payment Amount |
116651.23 |
Total Medicare Standardized Payment Amount |
124839.9 |
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 |
189 |
Number Of Medical Services |
4796 |
Number Of Medicare Beneficiaries With Medical Services |
2421 |
Total Medical Submitted Charge Amount |
435310 |
Total Medical Medicare Allowed Amount |
148759.71 |
Total Medical Medicare Payment Amount |
116651.23 |
Total Medical Medicare Standardized Payment Amount |
124839.9 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
275 |
Number Of Beneficiaries Age 65 to 74 |
975 |
Number Of Beneficiaries Age 75 to 84 |
754 |
Number Of Beneficiaries Age Greater 84 |
417 |
Number Of Female Beneficiaries |
1437 |
Number Of Male Beneficiaries |
984 |
Number Of Non Hispanic White Beneficiaries |
2339 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
2014 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
407 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3748 |