National Provider Identifier [NPI]: |
1831153808 |
Last Name Of The Provider |
DUESDIEKER |
First Name Of The Provider |
GILES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
559 ABBOTT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALINAS |
Zip Code Of The Provider |
939014325 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
303 |
Number Of Services |
10336 |
Number Of Medicare Beneficiaries |
2247 |
Total Submitted Charge Amount |
1207896.6 |
Total Medicare Allowed Amount |
258531.3 |
Total Medicare Payment Amount |
196619.38 |
Total Medicare Standardized Payment Amount |
192875.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
6220 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
6049.6 |
Total Drug Medicare AllowedAmount |
1286.73 |
Total Drug Medicare PaymentAmount |
1008.74 |
Total Drug Medicare Standardized Payment Amount |
1008.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
300 |
Number Of Medical Services |
4116 |
Number Of Medicare Beneficiaries With Medical Services |
2247 |
Total Medical Submitted Charge Amount |
1201847 |
Total Medical Medicare Allowed Amount |
257244.57 |
Total Medical Medicare Payment Amount |
195610.64 |
Total Medical Medicare Standardized Payment Amount |
191866.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
433 |
Number Of Beneficiaries Age 65 to 74 |
753 |
Number Of Beneficiaries Age 75 to 84 |
658 |
Number Of Beneficiaries Age Greater 84 |
403 |
Number Of Female Beneficiaries |
1310 |
Number Of Male Beneficiaries |
937 |
Number Of Non Hispanic White Beneficiaries |
1023 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
116 |
Number Of Hispanic Beneficiaries |
1027 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
941 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9312 |