National Provider Identifier [NPI]: |
1295714251 |
Last Name Of The Provider |
SENIOR |
First Name Of The Provider |
DALE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9880 ANGIES WAY |
Street Address 2 Of The Provider |
STE. 410 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402412851 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
6720 |
Number Of Medicare Beneficiaries |
1925 |
Total Submitted Charge Amount |
458232 |
Total Medicare Allowed Amount |
233919.76 |
Total Medicare Payment Amount |
169784.08 |
Total Medicare Standardized Payment Amount |
180288.7 |
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 |
62 |
Number Of Medical Services |
6720 |
Number Of Medicare Beneficiaries With Medical Services |
1925 |
Total Medical Submitted Charge Amount |
458232 |
Total Medical Medicare Allowed Amount |
233919.76 |
Total Medical Medicare Payment Amount |
169784.08 |
Total Medical Medicare Standardized Payment Amount |
180288.7 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
327 |
Number Of Beneficiaries Age 65 to 74 |
658 |
Number Of Beneficiaries Age 75 to 84 |
588 |
Number Of Beneficiaries Age Greater 84 |
352 |
Number Of Female Beneficiaries |
1050 |
Number Of Male Beneficiaries |
875 |
Number Of Non Hispanic White Beneficiaries |
1748 |
Number Of Black or African American Beneficiaries |
140 |
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 |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
1457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
468 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6246 |