National Provider Identifier [NPI]: |
1275532590 |
Last Name Of The Provider |
DUNKLE |
First Name Of The Provider |
CHAD |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
903 NW WASHINGTON BLVD |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
HAMILTON |
Zip Code Of The Provider |
450136386 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1380 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
151997 |
Total Medicare Allowed Amount |
93187.95 |
Total Medicare Payment Amount |
63326.03 |
Total Medicare Standardized Payment Amount |
67087.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
187 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
6475 |
Total Drug Medicare AllowedAmount |
4140.35 |
Total Drug Medicare PaymentAmount |
3932.29 |
Total Drug Medicare Standardized Payment Amount |
3932.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1193 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
145522 |
Total Medical Medicare Allowed Amount |
89047.6 |
Total Medical Medicare Payment Amount |
59393.74 |
Total Medical Medicare Standardized Payment Amount |
63155.08 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
256 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.7911 |