National Provider Identifier [NPI]: |
1427030956 |
Last Name Of The Provider |
DUNTEMAN |
First Name Of The Provider |
EDWIN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 N NEW BALLAS RD |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
CREVE COEUR |
Zip Code Of The Provider |
631416835 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
4737 |
Number Of Medicare Beneficiaries |
455 |
Total Submitted Charge Amount |
683994.51 |
Total Medicare Allowed Amount |
295197.95 |
Total Medicare Payment Amount |
211928.44 |
Total Medicare Standardized Payment Amount |
219364.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
1955 |
Number Of Medicare Beneficiaries With Drug Services |
181 |
Total Drug Submitted ChargeAmount |
22400.5 |
Total Drug Medicare AllowedAmount |
6334.65 |
Total Drug Medicare PaymentAmount |
4033.75 |
Total Drug Medicare Standardized Payment Amount |
4033.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
2782 |
Number Of Medicare Beneficiaries With Medical Services |
455 |
Total Medical Submitted Charge Amount |
661594.01 |
Total Medical Medicare Allowed Amount |
288863.3 |
Total Medical Medicare Payment Amount |
207894.69 |
Total Medical Medicare Standardized Payment Amount |
215331.14 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
316 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
402 |
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 |
421 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6991 |