National Provider Identifier [NPI]: |
1700086089 |
Last Name Of The Provider |
DALKIN |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5240 E KNIGHT DR |
Street Address 2 Of The Provider |
STE 108 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857122122 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
558 |
Number Of Medicare Beneficiaries |
274 |
Total Submitted Charge Amount |
220913.76 |
Total Medicare Allowed Amount |
81436.73 |
Total Medicare Payment Amount |
60763.67 |
Total Medicare Standardized Payment Amount |
58293.86 |
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 |
52 |
Number Of Medical Services |
558 |
Number Of Medicare Beneficiaries With Medical Services |
274 |
Total Medical Submitted Charge Amount |
220913.76 |
Total Medical Medicare Allowed Amount |
81436.73 |
Total Medical Medicare Payment Amount |
60763.67 |
Total Medical Medicare Standardized Payment Amount |
58293.86 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
14 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
217 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
4 |
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3134 |