National Provider Identifier [NPI]: |
1750352100 |
Last Name Of The Provider |
MCDERMOTT |
First Name Of The Provider |
CORNELIUS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3370 N. HAYDEN RD |
Street Address 2 Of The Provider |
#123-407 |
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
85251 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
642 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
185798 |
Total Medicare Allowed Amount |
109866.03 |
Total Medicare Payment Amount |
84912.4 |
Total Medicare Standardized Payment Amount |
86506.59 |
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 |
18 |
Number Of Medical Services |
642 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
185798 |
Total Medical Medicare Allowed Amount |
109866.03 |
Total Medical Medicare Payment Amount |
84912.4 |
Total Medical Medicare Standardized Payment Amount |
86506.59 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
230 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
11 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
220 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.3227 |