National Provider Identifier [NPI]: |
1619178159 |
Last Name Of The Provider |
DEMBIEC |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 LACEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CAPE GIRARDEAU |
Zip Code Of The Provider |
637015230 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1942 |
Number Of Medicare Beneficiaries |
869 |
Total Submitted Charge Amount |
411260 |
Total Medicare Allowed Amount |
259907.17 |
Total Medicare Payment Amount |
193022.2 |
Total Medicare Standardized Payment Amount |
176692.97 |
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 |
18 |
Number Of Medical Services |
1942 |
Number Of Medicare Beneficiaries With Medical Services |
869 |
Total Medical Submitted Charge Amount |
411260 |
Total Medical Medicare Allowed Amount |
259907.17 |
Total Medical Medicare Payment Amount |
193022.2 |
Total Medical Medicare Standardized Payment Amount |
176692.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
211 |
Number Of Beneficiaries Age 65 to 74 |
262 |
Number Of Beneficiaries Age 75 to 84 |
232 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
503 |
Number Of Male Beneficiaries |
366 |
Number Of Non Hispanic White Beneficiaries |
833 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
638 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
231 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1618 |