National Provider Identifier [NPI]: |
1790770964 |
Last Name Of The Provider |
HORNBACK |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11141 PARKVIEW PLAZA DR STE 110 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468451701 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1716 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
352425 |
Total Medicare Allowed Amount |
117402.98 |
Total Medicare Payment Amount |
90275.76 |
Total Medicare Standardized Payment Amount |
84686.01 |
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 |
45 |
Number Of Medical Services |
1716 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
352425 |
Total Medical Medicare Allowed Amount |
117402.98 |
Total Medical Medicare Payment Amount |
90275.76 |
Total Medical Medicare Standardized Payment Amount |
84686.01 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
159 |
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 |
163 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
72 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1633 |