Medicare Facts for Dr. Maxwell J. Self, MD


National Provider Identifier [NPI]: 1497736011
Last Name Of The Provider SELF
First Name Of The Provider MAXWELL
Middle Initial Of The Provider J
Credentials Of The Provider M.D.
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 403 WOODLAND HILLS BLVD
Street Address 2 Of The Provider
City Of The Provider FORT SCOTT
Zip Code Of The Provider 667018798
State Code Of The Provider KS
Country Code Of The Provider US
Provider Type Of The Provider Family Practice
Medicare Participation Indicator Y
Number Of HCPCS 128
Number Of Services 9744
Number Of Medicare Beneficiaries 637
Total Submitted Charge Amount 500670.8
Total Medicare Allowed Amount 287496.13
Total Medicare Payment Amount 204971.64
Total Medicare Standardized Payment Amount 214257.72
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 49
Number Of Drug Services 6856
Number Of Medicare Beneficiaries With Drug Services 225
Total Drug Submitted ChargeAmount 218792.8
Total Drug Medicare AllowedAmount 95924.3
Total Drug Medicare PaymentAmount 75464.04
Total Drug Medicare Standardized Payment Amount 75464.04
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 79
Number Of Medical Services 2888
Number Of Medicare Beneficiaries With Medical Services 637
Total Medical Submitted Charge Amount 281878
Total Medical Medicare Allowed Amount 191571.83
Total Medical Medicare Payment Amount 129507.6
Total Medical Medicare Standardized Payment Amount 138793.68
Average Age Of Beneficiaries 73
Number Of Beneficiaries Age Less65 126
Number Of Beneficiaries Age 65 to 74 217
Number Of Beneficiaries Age 75 to 84 167
Number Of Beneficiaries Age Greater 84 127
Number Of Female Beneficiaries 367
Number Of Male Beneficiaries 270
Number Of Non Hispanic White Beneficiaries 617
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 462
Number Of Beneficiaries With Medicare Medicaid Entitlement 175
Percent Of With Atrial Fibrillation 12
Percent Of With Alzheimers Disease or Dementia 11
Percent Of With Asthma 7
Percent Of With Cancer 12
Percent Of With Heart Failure 18
Percent Of With Chronic Kidney Disease 16
Percent Of With Chronic Obstructive Pulmonary Disease 17
Percent Of With Depression 25
Percent Of With Diabetes 32
Percent Of With Hyperlipidemia 50
Percent Of With Hypertension 63
Percent Of With Ischemic Heart Disease 30
Percent Of With Osteoporosis 6
Percent Of With Rheumatoid Arthritis Osteoarthritis 34
Percent Of With Schizophrenia Other PsychoticDisorders 6
Percent Of With Stroke 4
Average HCC Risk Score Of Beneficiaries 1.1806

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