National Provider Identifier [NPI]: |
1114003415 |
Last Name Of The Provider |
ANTHONY |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
276 KINGSBURY GRADE |
Street Address 2 Of The Provider |
SUITE 101 B 5910 |
City Of The Provider |
STATELINE |
Zip Code Of The Provider |
894499804 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
5954 |
Number Of Medicare Beneficiaries |
770 |
Total Submitted Charge Amount |
747225 |
Total Medicare Allowed Amount |
412451.96 |
Total Medicare Payment Amount |
314933.65 |
Total Medicare Standardized Payment Amount |
293261.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
2780 |
Total Drug Medicare AllowedAmount |
2291.94 |
Total Drug Medicare PaymentAmount |
1796.88 |
Total Drug Medicare Standardized Payment Amount |
1796.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
98 |
Number Of Medical Services |
5913 |
Number Of Medicare Beneficiaries With Medical Services |
770 |
Total Medical Submitted Charge Amount |
744445 |
Total Medical Medicare Allowed Amount |
410160.02 |
Total Medical Medicare Payment Amount |
313136.77 |
Total Medical Medicare Standardized Payment Amount |
291464.98 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
402 |
Number Of Beneficiaries Age 75 to 84 |
243 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
385 |
Number Of Male Beneficiaries |
385 |
Number Of Non Hispanic White Beneficiaries |
730 |
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 |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
732 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8692 |