National Provider Identifier [NPI]: |
1306863378 |
Last Name Of The Provider |
DUVALL |
First Name Of The Provider |
VICTOR |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
625 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLARKSON |
Zip Code Of The Provider |
427267044 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
6233 |
Number Of Medicare Beneficiaries |
522 |
Total Submitted Charge Amount |
394142 |
Total Medicare Allowed Amount |
234510.99 |
Total Medicare Payment Amount |
156607.59 |
Total Medicare Standardized Payment Amount |
170264.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
1371 |
Number Of Medicare Beneficiaries With Drug Services |
255 |
Total Drug Submitted ChargeAmount |
24480 |
Total Drug Medicare AllowedAmount |
8781.47 |
Total Drug Medicare PaymentAmount |
7894.65 |
Total Drug Medicare Standardized Payment Amount |
7894.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
4862 |
Number Of Medicare Beneficiaries With Medical Services |
522 |
Total Medical Submitted Charge Amount |
369662 |
Total Medical Medicare Allowed Amount |
225729.52 |
Total Medical Medicare Payment Amount |
148712.94 |
Total Medical Medicare Standardized Payment Amount |
162370.23 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
264 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0226 |