National Provider Identifier [NPI]: |
1023265840 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
JARED |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3501 N SCOTTSDALE RD |
Street Address 2 Of The Provider |
SUITE 130 |
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852515648 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
156 |
Number Of Services |
110236 |
Number Of Medicare Beneficiaries |
3767 |
Total Submitted Charge Amount |
3447395.7 |
Total Medicare Allowed Amount |
774753.77 |
Total Medicare Payment Amount |
587602.66 |
Total Medicare Standardized Payment Amount |
611668.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
103726 |
Number Of Medicare Beneficiaries With Drug Services |
1022 |
Total Drug Submitted ChargeAmount |
214233.7 |
Total Drug Medicare AllowedAmount |
27920.47 |
Total Drug Medicare PaymentAmount |
21690.92 |
Total Drug Medicare Standardized Payment Amount |
21690.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
150 |
Number Of Medical Services |
6510 |
Number Of Medicare Beneficiaries With Medical Services |
3767 |
Total Medical Submitted Charge Amount |
3233162 |
Total Medical Medicare Allowed Amount |
746833.3 |
Total Medical Medicare Payment Amount |
565911.74 |
Total Medical Medicare Standardized Payment Amount |
589977.61 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
198 |
Number Of Beneficiaries Age 65 to 74 |
1780 |
Number Of Beneficiaries Age 75 to 84 |
1231 |
Number Of Beneficiaries Age Greater 84 |
558 |
Number Of Female Beneficiaries |
2031 |
Number Of Male Beneficiaries |
1736 |
Number Of Non Hispanic White Beneficiaries |
3473 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
35 |
Number Of Hispanic Beneficiaries |
110 |
Number Of American Indian Alaska Native Beneficiaries |
33 |
Number Of Beneficiaries With Race Not Else where Classified |
56 |
Number Of Beneficiaries With Medicare Only Entitlement |
3545 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
222 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.403 |