National Provider Identifier [NPI]: |
1043222623 |
Last Name Of The Provider |
DUNNETT |
First Name Of The Provider |
CHERYL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8501 WILSHIRE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEVERLY HILLS |
Zip Code Of The Provider |
90211 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
662 |
Number Of Medicare Beneficiaries |
126 |
Total Submitted Charge Amount |
118094 |
Total Medicare Allowed Amount |
41158.75 |
Total Medicare Payment Amount |
29210.69 |
Total Medicare Standardized Payment Amount |
26843.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
44 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
1985 |
Total Drug Medicare AllowedAmount |
1130.45 |
Total Drug Medicare PaymentAmount |
1107.77 |
Total Drug Medicare Standardized Payment Amount |
1107.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
618 |
Number Of Medicare Beneficiaries With Medical Services |
125 |
Total Medical Submitted Charge Amount |
116109 |
Total Medical Medicare Allowed Amount |
40028.3 |
Total Medical Medicare Payment Amount |
28102.92 |
Total Medical Medicare Standardized Payment Amount |
25735.46 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
65 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
88 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0737 |