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Order and Refer Eligibility

Source: R/end-order_refer.R
order_refer.Rd

Eligibility to order and refer within Medicare

Usage

order_refer(
  npi = NULL,
  first = NULL,
  last = NULL,
  ptb = NULL,
  dme = NULL,
  hha = NULL,
  pmd = NULL,
  hospice = NULL,
  count = FALSE,
  set = FALSE
)

Arguments

npi

<int> National Provider Identifier

first, last

<chr> Individual provider's first/last name

ptb, dme, hha, pmd, hospice

<lgl> Eligibility for:

  • ptb: Medicare Part B

  • dme: Durable Medical Equipment

  • hha: Home Health Agency

  • pmd: Power Mobility Devices

  • hospice: Hospice

count

<lgl> Return the dataset's total row count

set

<lgl> Return the entire dataset

Value

A tibble

Criteria

  • Individual NPI

  • Medicare enrollment with Approved or Opt-Out status

  • Eligible specialty type

Types

  • Ordering: can order non-physician services for patients.

  • Referring/Certifying: can request items/services Medicare may reimburse.

  • Opt-Out: can enroll solely to order and refer.

Services

  • Medicare Part B: Clinical Labs, Imaging

  • Medicare Part A: Home Health

  • DMEPOS: Durable medical equipment, prosthetics, orthotics, & supplies

References

Examples

order_refer(count = TRUE)
#> order_refer Totals
#> • Rows  : 2,000,076
#> • Pages : 401      
#> 

order_refer(npi = 1003026055)
#> ✔ order_refer returned 1 result.
#> # A tibble: 1 × 8
#>   first   last          npi   ptb   dme   hha   pmd hospice
#>   <chr>   <chr>       <int> <int> <int> <int> <int>   <int>
#> 1 RADHIKA PHADKE 1003026055     0     1     0     1       0

order_refer(first = "Jennifer", last = "Smith")
#> ✔ order_refer returned 136 results.
#> # A tibble: 136 × 8
#>    first    last         npi   ptb   dme   hha   pmd hospice
#>    <chr>    <chr>      <int> <int> <int> <int> <int>   <int>
#>  1 JENNIFER SMITH 1346518990     1     1     1     0       1
#>  2 JENNIFER SMITH 1366164576     1     1     1     1       0
#>  3 JENNIFER SMITH 1497230395     1     1     1     1       0
#>  4 JENNIFER SMITH 1588617773     1     1     1     1       0
#>  5 JENNIFER SMITH 1073921029     1     1     1     1       0
#>  6 JENNIFER SMITH 1134917859     1     1     1     1       0
#>  7 JENNIFER SMITH 1417514035     1     1     1     1       0
#>  8 JENNIFER SMITH 1972574770     1     1     1     1       1
#>  9 JENNIFER SMITH 1316939655     1     1     1     1       0
#> 10 JENNIFER SMITH 1265417687     0     1     0     1       0
#> # ℹ 126 more rows

order_refer(ptb = TRUE, dme = TRUE, hha = FALSE, pmd = TRUE, hospice = FALSE)
#> ✔ order_refer returned 47 results.
#> # A tibble: 47 × 8
#>    first     last               npi   ptb   dme   hha   pmd hospice
#>    <chr>     <chr>            <int> <int> <int> <int> <int>   <int>
#>  1 ROBYN     AYER        1659094290     1     1     0     1       0
#>  2 MEGAN     BAUMGARDNER 1023796711     1     1     0     1       0
#>  3 KRISTINA  BERRY       1295461192     1     1     0     1       0
#>  4 BONNIE    BETTS       1306821129     1     1     0     1       0
#>  5 LAURA     BOBROWSKI   1013297019     1     1     0     1       0
#>  6 ALEXANDRA BROWN       1649046129     1     1     0     1       0
#>  7 KAELYN    CARROLL     1003706912     1     1     0     1       0
#>  8 BRIDGET   DIETZ       1720522592     1     1     0     1       0
#>  9 JAMIE     DUBOSE      1720506520     1     1     0     1       0
#> 10 ANNA      DYKSTRA     1174278626     1     1     0     1       0
#> # ℹ 37 more rows