National Provider Identifier [NPI]: |
1962496562 |
Last Name Of The Provider |
HARRIS |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7340 SHADELAND STATION |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462563980 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
170 |
Number Of Services |
10451 |
Number Of Medicare Beneficiaries |
6891 |
Total Submitted Charge Amount |
1525469.5 |
Total Medicare Allowed Amount |
366395.81 |
Total Medicare Payment Amount |
279013.75 |
Total Medicare Standardized Payment Amount |
299195.05 |
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 |
170 |
Number Of Medical Services |
10451 |
Number Of Medicare Beneficiaries With Medical Services |
6891 |
Total Medical Submitted Charge Amount |
1525469.5 |
Total Medical Medicare Allowed Amount |
366395.81 |
Total Medical Medicare Payment Amount |
279013.75 |
Total Medical Medicare Standardized Payment Amount |
299195.05 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
1280 |
Number Of Beneficiaries Age 65 to 74 |
2596 |
Number Of Beneficiaries Age 75 to 84 |
2004 |
Number Of Beneficiaries Age Greater 84 |
1011 |
Number Of Female Beneficiaries |
4165 |
Number Of Male Beneficiaries |
2726 |
Number Of Non Hispanic White Beneficiaries |
6638 |
Number Of Black or African American Beneficiaries |
124 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
50 |
Number Of Beneficiaries With Medicare Only Entitlement |
5290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1601 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.589 |