National Provider Identifier [NPI]: |
1780685453 |
Last Name Of The Provider |
DALE |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2240 GAUSE BLVD E |
Street Address 2 Of The Provider |
|
City Of The Provider |
SLIDELL |
Zip Code Of The Provider |
704614231 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1442 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
295602.24 |
Total Medicare Allowed Amount |
140062.99 |
Total Medicare Payment Amount |
108009.48 |
Total Medicare Standardized Payment Amount |
110063.38 |
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 |
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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 |
70 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
281 |
Number Of Black or African American Beneficiaries |
58 |
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
32 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
75 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.4602 |