ALAN CARTMELL M.D.
NPI 1316933021
Specialist in Bakersfield, CA

Medicare Participation & PECOS Enrollment Status

Alan Cartmell is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

3d radiographic procedure with computerized image postprocessing

A 3D radiographic procedure with computerized image postprocessing is a high-tech imaging test. It uses X-rays to create detailed 3D images of the body. The computerized postprocessing further enhances these images for more precise diagnosis and treatment planning.

This service was performed 78 times for 60 patients

Beta-2 microglobulin (protein) level

The Beta-2 microglobulin level test measures the amount of this protein in your blood. It's often used to check kidney function or monitor certain cancers. High levels may indicate a health issue. The test involves a simple blood draw.

This service was performed 231 times for 56 patients

Blood creatinine level

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

This service was performed 53 times for 48 patients

Blood test, basic group of blood chemicals (calcium, total)

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

This service was performed 18 times for 12 patients

Blood test, clotting time

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

This service was performed 218 times for 76 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 1,741 times for 450 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 38 times for 31 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 194 times for 108 patients

Carcinoembryonic antigen (cea) protein level

Carcinoembryonic Antigen (CEA) protein level is a blood test often used in cancer care. It measures the amount of CEA protein in your blood, which can increase in cases of certain types of cancer. It's used to monitor treatment progress and check for cancer recurrence.

This service was performed 469 times for 150 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

This service was performed 21 times for 17 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 718 times for 152 patients

Coagulation assessment blood test, plasma or whole blood

A coagulation assessment blood test evaluates how well your blood clots, helping identify potential bleeding or clotting disorders. This test uses a sample of your plasma or whole blood. It's a standard procedure to ensure your body's clotting process is functioning properly.

This service was performed 135 times for 74 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 2,385 times for 457 patients

Complete ultrasound scan of 1 breast

A complete ultrasound scan of one breast is a non-invasive imaging test that uses sound waves to create detailed images of the inside of your breast. It helps in detecting any abnormalities or changes, ensuring your breast health.

This service was performed 21 times for 18 patients

Complete ultrasound scan of abdomen

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

This service was performed 43 times for 42 patients

Ct scan of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

This service was performed 39 times for 37 patients

Ct scan of chest with contrast

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

This service was performed 57 times for 46 patients

Ct scan of chest without contrast

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

This service was performed 14 times for 12 patients

Ct scan of soft tissue of neck with contrast

A CT scan of the neck with contrast is a non-invasive imaging procedure. A special dye is administered to highlight the soft tissues in your neck, making them easier to see. This helps detect issues like infections, tumors, or other abnormalities.

This service was performed 13 times for 12 patients

Cyanocobalamin (vitamin b-12) level

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

This service was performed 276 times for 173 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.

This service was performed 60 times for 55 patients

Diagnostic mammography of 1 breast

Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.

This service was performed 23 times for 23 patients

Diagnostic mammography of both breasts

Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.

This service was performed 51 times for 49 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 19 times for 18 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 278 times for 198 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 597 times for 308 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 83 times for 64 patients

Ferritin (blood protein) level

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

This service was performed 498 times for 196 patients

Flow cytometry technique for dna or cell analysis, each additional marker

Flow cytometry is a technique that helps analyze the physical and chemical characteristics of cells or particles. When an additional marker is used, it aids in identifying specific cell types or stages of disease. This helps in precise diagnosis and treatment planning.

This service was performed 258 times for 12 patients

Flow cytometry technique for dna or cell analysis, first marker

Flow cytometry is a technique used to examine microscopic particles, like cells or DNA. It employs a beam of light to detect and measure physical and chemical characteristics of these particles. The 'first marker' refers to a specific characteristic or feature used to identify a particular cell or particle.

This service was performed 13 times for 12 patients

Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries

Fluorodeoxyglucose F-18 FDG is a radioactive drug used in PET scans. It helps doctors see how your tissues and organs are functioning. The drug is given in a specific dose, up to 45 millicuries, depending on your body size and the type of scan.

This service was performed 116 times for 84 patients

Folic acid level, serum

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

This service was performed 274 times for 165 patients

Gammaglobulin (immune system protein) measurement

Gammaglobulin measurement is a blood test that checks the levels of certain proteins (gammaglobulins) that the body uses to fight infections. High or low levels can indicate various health conditions. It's a simple, quick procedure with minimal discomfort.

This service was performed 565 times for 72 patients

Immunologic analysis for detection of tumor antigen, quantitative; ca 15-3

This is a blood test that measures the level of CA 15-3, a protein often higher in individuals with certain types of cancer. It helps monitor response to treatment and check for cancer recurrence. It's not a standalone diagnostic test but used alongside other evaluations.

This service was performed 286 times for 84 patients

Injection of drug or substance into vein

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

This service was performed 93 times for 71 patients

Injection, furosemide, up to 20 mg

Furosemide is a medication given via injection, often to help your body eliminate excess fluid or salt. It's typically used to treat issues like heart failure or high blood pressure. The dose mentioned, up to 20 mg, will be adjusted based on your specific needs.

This service was performed 73 times for 59 patients

Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml

This is an MRI procedure where a gadolinium-based contrast agent is injected into your body. The agent enhances the images, making it easier to detect abnormalities. It's safe and side effects are rare. It's administered per milliliter as needed.

This service was performed 645 times for 32 patients

Injection, gadoterate meglumine, 0.1 ml

Gadoterate meglumine is a contrast agent used in MRI scans to help visualize certain areas of your body more clearly. It's injected into your bloodstream, typically through a vein in your arm, and helps doctors get more detailed images.

This service was performed 8,450 times for 36 patients

Injection, lorazepam, 2 mg

Lorazepam 2 mg injection is a medication given to manage anxiety disorders, insomnia, or seizure activity. It works by calming the brain and nerves. It's usually administered by a healthcare professional in a hospital or clinic setting.

This service was performed 32 times for 24 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 1,299 times for 401 patients

Iron level

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

This service was performed 458 times for 188 patients

Lactate dehydrogenase (enzyme) level

A Lactate Dehydrogenase level test measures the amount of this enzyme in your body. It's often done when tissue damage is suspected, as high levels can indicate issues like heart disease, lung disease, liver disease, or blood disorders. This test helps in diagnosing and monitoring these conditions.

This service was performed 1,995 times for 450 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 7,880 times for 69 patients

Magnesium level

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

This service was performed 1,755 times for 366 patients

Manual urinalysis test with examination using microscope, non-automated

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

This service was performed 133 times for 78 patients

Measurement c-reactive protein for detection of infection or inflammation

C-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.

This service was performed 37 times for 32 patients

Mri scan of abdomen before and after contrast

An MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.

This service was performed 17 times for 14 patients

Mri scan of bone of eye socket, face, and/or neck before and after contrast

An MRI scan of the eye socket, face, and/or neck uses magnetic fields to create detailed images of these areas. Contrast dye helps highlight specific tissues for clearer pictures. It's non-invasive, aids in detecting abnormalities, and guides treatment plans.

This service was performed 13 times for 12 patients

Mri scan of both breasts

An MRI scan of both breasts is a non-invasive procedure using magnetic fields and radio waves to create detailed images of your chest area. This aids in detecting any abnormalities, ensuring your health and well-being.

This service was performed 18 times for 18 patients

Mri scan of brain before and after contrast

An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.

This service was performed 17 times for 15 patients

Mri scan of pelvis before and after contrast

An MRI scan of the pelvis before and after contrast is a non-invasive imaging technique. It uses magnetic fields and radio waves to capture detailed images of your lower abdomen. Contrast dye, safe for the body, improves image clarity. This helps detect abnormalities more accurately.

This service was performed 19 times for 16 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 75 times for 75 patients

Nuclear medicine study from skull base to mid-thigh with ct scan

A nuclear medicine study from skull base to mid-thigh with a CT scan involves using a small amount of radioactive material and CT imaging to examine body tissues and organs. This helps detect any abnormalities by providing detailed images of the body's internal structure.

This service was performed 110 times for 78 patients

Nuclear medicine study of bone and/or joint whole body

A nuclear medicine study of bone and/or joint whole body involves injecting a small amount of radioactive material into your body. This material travels to your bones and emits energy. A special camera captures this energy, creating images of your bones to help identify any abnormalities.

This service was performed 26 times for 23 patients

Nuclear medicine study whole body with ct scan

A Nuclear Medicine Study with a CT Scan is a diagnostic procedure. It uses a small amount of radioactive substance and a CT scan to create detailed images of your body. These images help doctors diagnose, monitor, and treat various conditions.

This service was performed 15 times for 12 patients

Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a

The Oncology Care Model (OCM) Monthly Enhanced Oncology Services (MEOS) payment, denoted by G9678, is a compensation method for OCM practitioners. These payments are specifically for providing additional, or "enhanced", services to OCM beneficiaries, as outlined in the OCM participation agreement.

This service was performed 134 times for 42 patients

Prealbumin (protein) level

A Prealbumin (protein) level test measures the amount of prealbumin in your blood. Prealbumin is a protein made by your liver and helps carry vitamins and hormones through your body. Low levels could indicate malnutrition, liver disease, or other health issues.

This service was performed 34 times for 18 patients

Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month

Principal care management services focus on managing a single high-risk disease. This involves a health care professional directing clinical staff for the first 30 minutes each month. The aim is to monitor your health, coordinate care, and provide necessary support for your disease management.

This service was performed 41 times for 16 patients

Prostate cancer screening; prostate specific antigen test (psa)

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

This service was performed 27 times for 27 patients

Psa (prostate specific antigen) measurement, total

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

This service was performed 256 times for 88 patients

Red blood count automated, with additional calculations

An automated red blood cell count is a laboratory test that counts the number of red blood cells in your blood. This test also includes additional calculations to measure the size, volume, and hemoglobin concentration of these cells. It helps to identify any abnormalities in your blood.

This service was performed 316 times for 108 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 31 times for 29 patients

Screening 3d breast mammography

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

This service was performed 50 times for 50 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 50 times for 50 patients

Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries

Technetium Tc-99m Medronate is a diagnostic procedure that uses a small amount of radioactive material to examine the health of your bones. It helps to detect bone diseases or abnormalities. The procedure is safe, with the radioactive substance naturally leaving your body after the test.

This service was performed 26 times for 23 patients

Testosterone (hormone) level, total

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

This service was performed 126 times for 56 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 174 times for 101 patients

Thyroxine (thyroid chemical), total

A Thyroxine (thyroid chemical) total test measures the amount of thyroxine, a hormone produced by your thyroid gland, in your blood. This hormone helps regulate your body's metabolism. The test can help diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism.

This service was performed 14 times for 12 patients

Transferrin (iron binding protein) level

A transferrin level test measures the amount of transferrin, a protein that carries iron, in your blood. This can help determine if your body has an iron deficiency or overload. It's a simple blood test and can provide valuable information about your overall health.

This service was performed 488 times for 196 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 26 times for 22 patients

Urea nitrogen level to assess kidney function, quantitative

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

This service was performed 51 times for 47 patients

Uric acid level, blood

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

This service was performed 1,992 times for 449 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 51 times for 44 patients

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 86.69, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 86.69 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: 76.99

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: 93

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: 40

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: 63.03

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: 63.03

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1316933021 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

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Frequently Asked Questions