National Provider Identifier [NPI]: |
1023082484 |
Last Name Of The Provider |
PALLARES |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4402 CHURCHMAN AVE |
Street Address 2 Of The Provider |
SUITE 401 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402151190 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
9318 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
185590 |
Total Medicare Allowed Amount |
116011.77 |
Total Medicare Payment Amount |
86811.5 |
Total Medicare Standardized Payment Amount |
90225.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
1485 |
Total Drug Medicare AllowedAmount |
996.53 |
Total Drug Medicare PaymentAmount |
976.55 |
Total Drug Medicare Standardized Payment Amount |
976.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
9275 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
184105 |
Total Medical Medicare Allowed Amount |
115015.24 |
Total Medical Medicare Payment Amount |
85834.95 |
Total Medical Medicare Standardized Payment Amount |
89249.09 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
185 |
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 |
158 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
40 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1143 |