National Provider Identifier [NPI]: |
1861416372 |
Last Name Of The Provider |
RIVES |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 HEALTH CENTER DR |
Street Address 2 Of The Provider |
SUITE 305 |
City Of The Provider |
MATTOON |
Zip Code Of The Provider |
619389258 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
96 |
Number Of Services |
4147 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
674796 |
Total Medicare Allowed Amount |
183554.68 |
Total Medicare Payment Amount |
137806.21 |
Total Medicare Standardized Payment Amount |
141420.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
1963 |
Number Of Medicare Beneficiaries With Drug Services |
76 |
Total Drug Submitted ChargeAmount |
207054 |
Total Drug Medicare AllowedAmount |
32967.18 |
Total Drug Medicare PaymentAmount |
25642.95 |
Total Drug Medicare Standardized Payment Amount |
25642.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
2184 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
467742 |
Total Medical Medicare Allowed Amount |
150587.5 |
Total Medical Medicare Payment Amount |
112163.26 |
Total Medical Medicare Standardized Payment Amount |
115777.34 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
343 |
Number Of Non Hispanic White Beneficiaries |
428 |
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 |
357 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2354 |