National Provider Identifier [NPI]: |
1508091364 |
Last Name Of The Provider |
DARNELL |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 W 11TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462024108 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1136 |
Number Of Medicare Beneficiaries |
603 |
Total Submitted Charge Amount |
116564 |
Total Medicare Allowed Amount |
37337.21 |
Total Medicare Payment Amount |
29107.22 |
Total Medicare Standardized Payment Amount |
23841.65 |
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 |
27 |
Number Of Medical Services |
1136 |
Number Of Medicare Beneficiaries With Medical Services |
603 |
Total Medical Submitted Charge Amount |
116564 |
Total Medical Medicare Allowed Amount |
37337.21 |
Total Medical Medicare Payment Amount |
29107.22 |
Total Medical Medicare Standardized Payment Amount |
23841.65 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
335 |
Number Of Male Beneficiaries |
268 |
Number Of Non Hispanic White Beneficiaries |
520 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
429 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4601 |