National Provider Identifier [NPI]: |
1184648669 |
Last Name Of The Provider |
RIDEAU |
First Name Of The Provider |
ALECIA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4101 N ROXBORO ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DURHAM |
Zip Code Of The Provider |
277042121 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
3433 |
Number Of Medicare Beneficiaries |
1544 |
Total Submitted Charge Amount |
245371 |
Total Medicare Allowed Amount |
76597.77 |
Total Medicare Payment Amount |
66998.32 |
Total Medicare Standardized Payment Amount |
69777.62 |
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 |
22 |
Number Of Medical Services |
3433 |
Number Of Medicare Beneficiaries With Medical Services |
1544 |
Total Medical Submitted Charge Amount |
245371 |
Total Medical Medicare Allowed Amount |
76597.77 |
Total Medical Medicare Payment Amount |
66998.32 |
Total Medical Medicare Standardized Payment Amount |
69777.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
215 |
Number Of Beneficiaries Age 65 to 74 |
732 |
Number Of Beneficiaries Age 75 to 84 |
469 |
Number Of Beneficiaries Age Greater 84 |
128 |
Number Of Female Beneficiaries |
1527 |
Number Of Male Beneficiaries |
17 |
Number Of Non Hispanic White Beneficiaries |
1067 |
Number Of Black or African American Beneficiaries |
427 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
402 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0095 |