National Provider Identifier [NPI]: |
1447339452 |
Last Name Of The Provider |
DICUS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
917 BLANCO CIRCLE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALINAS |
Zip Code Of The Provider |
939014446 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
26034 |
Number Of Medicare Beneficiaries |
791 |
Total Submitted Charge Amount |
1217003.8 |
Total Medicare Allowed Amount |
731498.36 |
Total Medicare Payment Amount |
551458.9 |
Total Medicare Standardized Payment Amount |
543424.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
20061 |
Number Of Medicare Beneficiaries With Drug Services |
95 |
Total Drug Submitted ChargeAmount |
171578.8 |
Total Drug Medicare AllowedAmount |
95275.88 |
Total Drug Medicare PaymentAmount |
72308.76 |
Total Drug Medicare Standardized Payment Amount |
72308.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
5973 |
Number Of Medicare Beneficiaries With Medical Services |
791 |
Total Medical Submitted Charge Amount |
1045425 |
Total Medical Medicare Allowed Amount |
636222.48 |
Total Medical Medicare Payment Amount |
479150.14 |
Total Medical Medicare Standardized Payment Amount |
471115.89 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
221 |
Number Of Beneficiaries Age 65 to 74 |
265 |
Number Of Beneficiaries Age 75 to 84 |
214 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
368 |
Number Of Male Beneficiaries |
423 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
57 |
Number Of Hispanic Beneficiaries |
456 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
371 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
420 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.9736 |