National Provider Identifier [NPI]: |
1164562906 |
Last Name Of The Provider |
DIOP |
First Name Of The Provider |
DJIBY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 MEMORIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLEVILLE |
Zip Code Of The Provider |
622265360 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1650 |
Number Of Medicare Beneficiaries |
1044 |
Total Submitted Charge Amount |
1318880 |
Total Medicare Allowed Amount |
183233.42 |
Total Medicare Payment Amount |
140028.61 |
Total Medicare Standardized Payment Amount |
148625.78 |
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 |
14 |
Number Of Medical Services |
1650 |
Number Of Medicare Beneficiaries With Medical Services |
1044 |
Total Medical Submitted Charge Amount |
1318880 |
Total Medical Medicare Allowed Amount |
183233.42 |
Total Medical Medicare Payment Amount |
140028.61 |
Total Medical Medicare Standardized Payment Amount |
148625.78 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
310 |
Number Of Beneficiaries Age 65 to 74 |
296 |
Number Of Beneficiaries Age 75 to 84 |
277 |
Number Of Beneficiaries Age Greater 84 |
161 |
Number Of Female Beneficiaries |
606 |
Number Of Male Beneficiaries |
438 |
Number Of Non Hispanic White Beneficiaries |
913 |
Number Of Black or African American Beneficiaries |
120 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
659 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
385 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.8651 |