National Provider Identifier [NPI]: |
1730338906 |
Last Name Of The Provider |
DOLCE |
First Name Of The Provider |
KAREEM |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
368 MILAN AVE |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
NORWALK |
Zip Code Of The Provider |
448573106 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
1476 |
Number Of Medicare Beneficiaries |
366 |
Total Submitted Charge Amount |
198005.5 |
Total Medicare Allowed Amount |
90203.41 |
Total Medicare Payment Amount |
69482.28 |
Total Medicare Standardized Payment Amount |
71835.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
329 |
Total Drug Medicare AllowedAmount |
87.19 |
Total Drug Medicare PaymentAmount |
65.48 |
Total Drug Medicare Standardized Payment Amount |
65.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1429 |
Number Of Medicare Beneficiaries With Medical Services |
366 |
Total Medical Submitted Charge Amount |
197676.5 |
Total Medical Medicare Allowed Amount |
90116.22 |
Total Medical Medicare Payment Amount |
69416.8 |
Total Medical Medicare Standardized Payment Amount |
71769.92 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
351 |
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 |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6229 |