National Provider Identifier [NPI]: |
1194711697 |
Last Name Of The Provider |
OSBORNE |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 CARSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JONESBORO |
Zip Code Of The Provider |
724013104 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
114 |
Number Of Services |
3510 |
Number Of Medicare Beneficiaries |
419 |
Total Submitted Charge Amount |
238860 |
Total Medicare Allowed Amount |
108110.1 |
Total Medicare Payment Amount |
84280.28 |
Total Medicare Standardized Payment Amount |
91106.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
142 |
Number Of Medicare Beneficiaries With Drug Services |
93 |
Total Drug Submitted ChargeAmount |
3399 |
Total Drug Medicare AllowedAmount |
2376.99 |
Total Drug Medicare PaymentAmount |
2227.88 |
Total Drug Medicare Standardized Payment Amount |
2227.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
3368 |
Number Of Medicare Beneficiaries With Medical Services |
419 |
Total Medical Submitted Charge Amount |
235461 |
Total Medical Medicare Allowed Amount |
105733.11 |
Total Medical Medicare Payment Amount |
82052.4 |
Total Medical Medicare Standardized Payment Amount |
88878.48 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
374 |
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 |
265 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
154 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6974 |