National Provider Identifier [NPI]: |
1376649889 |
Last Name Of The Provider |
DUNST |
First Name Of The Provider |
MORDECAI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 E DUARTE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DUARTE |
Zip Code Of The Provider |
91010 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
664 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
301505.66 |
Total Medicare Allowed Amount |
74847.86 |
Total Medicare Payment Amount |
58365.11 |
Total Medicare Standardized Payment Amount |
55394 |
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 |
48 |
Number Of Medical Services |
664 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
301505.66 |
Total Medical Medicare Allowed Amount |
74847.86 |
Total Medical Medicare Payment Amount |
58365.11 |
Total Medical Medicare Standardized Payment Amount |
55394 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
154 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
39 |
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.8569 |