National Provider Identifier [NPI]: |
1992762785 |
Last Name Of The Provider |
RECEVEUR |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1930 BISHOP LN |
Street Address 2 Of The Provider |
SUITE 1600 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402181921 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
531 |
Number Of Medicare Beneficiaries |
290 |
Total Submitted Charge Amount |
51822 |
Total Medicare Allowed Amount |
36765.51 |
Total Medicare Payment Amount |
25489.04 |
Total Medicare Standardized Payment Amount |
27625.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
445 |
Total Drug Medicare AllowedAmount |
121.89 |
Total Drug Medicare PaymentAmount |
78.96 |
Total Drug Medicare Standardized Payment Amount |
78.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
507 |
Number Of Medicare Beneficiaries With Medical Services |
290 |
Total Medical Submitted Charge Amount |
51377 |
Total Medical Medicare Allowed Amount |
36643.62 |
Total Medical Medicare Payment Amount |
25410.08 |
Total Medical Medicare Standardized Payment Amount |
27546.93 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
257 |
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 |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9364 |