National Provider Identifier [NPI]: |
1982608410 |
Last Name Of The Provider |
KEANE |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4000 MIAMISBURG CENTERVILLE RD |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
MIAMISBURG |
Zip Code Of The Provider |
453423758 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1426 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
214075.56 |
Total Medicare Allowed Amount |
100075.51 |
Total Medicare Payment Amount |
73634.55 |
Total Medicare Standardized Payment Amount |
76768.73 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
293 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.611 |