National Provider Identifier [NPI]: |
1649368804 |
Last Name Of The Provider |
DRESBACH |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6825 S 27TH ST |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685124872 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
799 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
56505.75 |
Total Medicare Allowed Amount |
35936.7 |
Total Medicare Payment Amount |
25065.6 |
Total Medicare Standardized Payment Amount |
27468.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
224 |
Number Of Medicare Beneficiaries With Drug Services |
53 |
Total Drug Submitted ChargeAmount |
2176 |
Total Drug Medicare AllowedAmount |
1706.29 |
Total Drug Medicare PaymentAmount |
1542.62 |
Total Drug Medicare Standardized Payment Amount |
1542.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
575 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
54329.75 |
Total Medical Medicare Allowed Amount |
34230.41 |
Total Medical Medicare Payment Amount |
23522.98 |
Total Medical Medicare Standardized Payment Amount |
25926.07 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
178 |
Number Of Black or African American Beneficiaries |
|
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0421 |