National Provider Identifier [NPI]: |
1790030393 |
Last Name Of The Provider |
DIX |
First Name Of The Provider |
BROOKE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 HOSPITAL DR |
Street Address 2 Of The Provider |
BUILDING 1 |
City Of The Provider |
MOUNTAIN VIEW |
Zip Code Of The Provider |
940404106 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
2187 |
Number Of Medicare Beneficiaries |
523 |
Total Submitted Charge Amount |
153868 |
Total Medicare Allowed Amount |
136816.9 |
Total Medicare Payment Amount |
101909.89 |
Total Medicare Standardized Payment Amount |
91473.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2187 |
Number Of Medicare Beneficiaries With Medical Services |
523 |
Total Medical Submitted Charge Amount |
153868 |
Total Medical Medicare Allowed Amount |
136816.9 |
Total Medical Medicare Payment Amount |
101909.89 |
Total Medical Medicare Standardized Payment Amount |
91473.59 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
237 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
396 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
74 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
398 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2369 |