National Provider Identifier [NPI]: |
1528042256 |
Last Name Of The Provider |
ADAMS |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12469 EMERALD COAST PKWY W |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIRAMAR BEACH |
Zip Code Of The Provider |
325508305 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
6244 |
Number Of Medicare Beneficiaries |
1433 |
Total Submitted Charge Amount |
2500567 |
Total Medicare Allowed Amount |
1161948.9 |
Total Medicare Payment Amount |
885281.06 |
Total Medicare Standardized Payment Amount |
867948.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
160 |
Total Drug Medicare AllowedAmount |
28.46 |
Total Drug Medicare PaymentAmount |
22.34 |
Total Drug Medicare Standardized Payment Amount |
22.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
6228 |
Number Of Medicare Beneficiaries With Medical Services |
1433 |
Total Medical Submitted Charge Amount |
2500407 |
Total Medical Medicare Allowed Amount |
1161920.44 |
Total Medical Medicare Payment Amount |
885258.72 |
Total Medical Medicare Standardized Payment Amount |
867926.24 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
675 |
Number Of Beneficiaries Age 75 to 84 |
551 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
614 |
Number Of Male Beneficiaries |
819 |
Number Of Non Hispanic White Beneficiaries |
1418 |
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 |
1407 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9621 |