National Provider Identifier [NPI]: |
1982746863 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5434 GRAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW PORT RICHEY |
Zip Code Of The Provider |
346524008 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
6678 |
Number Of Medicare Beneficiaries |
1429 |
Total Submitted Charge Amount |
501441.64 |
Total Medicare Allowed Amount |
321556.67 |
Total Medicare Payment Amount |
242785.34 |
Total Medicare Standardized Payment Amount |
244746.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
60 |
Total Drug Medicare AllowedAmount |
35.79 |
Total Drug Medicare PaymentAmount |
28.04 |
Total Drug Medicare Standardized Payment Amount |
28.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
6658 |
Number Of Medicare Beneficiaries With Medical Services |
1429 |
Total Medical Submitted Charge Amount |
501381.64 |
Total Medical Medicare Allowed Amount |
321520.88 |
Total Medical Medicare Payment Amount |
242757.3 |
Total Medical Medicare Standardized Payment Amount |
244718.29 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
479 |
Number Of Beneficiaries Age Greater 84 |
531 |
Number Of Female Beneficiaries |
861 |
Number Of Male Beneficiaries |
568 |
Number Of Non Hispanic White Beneficiaries |
1342 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
311 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8142 |