National Provider Identifier [NPI]: |
1720072754 |
Last Name Of The Provider |
VANNESS |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
606 MAPLE VALLEY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGTON |
Zip Code Of The Provider |
636401976 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
155 |
Number Of Services |
7463 |
Number Of Medicare Beneficiaries |
939 |
Total Submitted Charge Amount |
2332213.84 |
Total Medicare Allowed Amount |
487780.47 |
Total Medicare Payment Amount |
362364.21 |
Total Medicare Standardized Payment Amount |
392184.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
2697 |
Number Of Medicare Beneficiaries With Drug Services |
455 |
Total Drug Submitted ChargeAmount |
293276.86 |
Total Drug Medicare AllowedAmount |
71380.98 |
Total Drug Medicare PaymentAmount |
54412.58 |
Total Drug Medicare Standardized Payment Amount |
54412.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
149 |
Number Of Medical Services |
4766 |
Number Of Medicare Beneficiaries With Medical Services |
938 |
Total Medical Submitted Charge Amount |
2038936.98 |
Total Medical Medicare Allowed Amount |
416399.49 |
Total Medical Medicare Payment Amount |
307951.63 |
Total Medical Medicare Standardized Payment Amount |
337772.4 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
268 |
Number Of Beneficiaries Age 65 to 74 |
333 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
583 |
Number Of Male Beneficiaries |
356 |
Number Of Non Hispanic White Beneficiaries |
918 |
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 |
677 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
262 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2008 |