National Provider Identifier [NPI]: |
1861403289 |
Last Name Of The Provider |
DUVAL |
First Name Of The Provider |
CHAD |
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 |
1600 S 48TH ST |
Street Address 2 Of The Provider |
ER DEPT |
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
68506 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
988 |
Number Of Medicare Beneficiaries |
722 |
Total Submitted Charge Amount |
429330.12 |
Total Medicare Allowed Amount |
117702.57 |
Total Medicare Payment Amount |
89437.68 |
Total Medicare Standardized Payment Amount |
95517 |
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 |
32 |
Number Of Medical Services |
988 |
Number Of Medicare Beneficiaries With Medical Services |
722 |
Total Medical Submitted Charge Amount |
429330.12 |
Total Medical Medicare Allowed Amount |
117702.57 |
Total Medical Medicare Payment Amount |
89437.68 |
Total Medical Medicare Standardized Payment Amount |
95517 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
211 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
163 |
Number Of Female Beneficiaries |
422 |
Number Of Male Beneficiaries |
300 |
Number Of Non Hispanic White Beneficiaries |
671 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
456 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
266 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6941 |