National Provider Identifier [NPI]: |
1851300974 |
Last Name Of The Provider |
JUNCK |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
223 N GUADALUPE ST |
Street Address 2 Of The Provider |
SUITE 466 |
City Of The Provider |
SANTA FE |
Zip Code Of The Provider |
875011868 |
State Code Of The Provider |
NM |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
345 |
Number Of Medicare Beneficiaries |
133 |
Total Submitted Charge Amount |
89051 |
Total Medicare Allowed Amount |
31450.5 |
Total Medicare Payment Amount |
24549.85 |
Total Medicare Standardized Payment Amount |
24370.82 |
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 |
13 |
Number Of Medical Services |
345 |
Number Of Medicare Beneficiaries With Medical Services |
133 |
Total Medical Submitted Charge Amount |
89051 |
Total Medical Medicare Allowed Amount |
31450.5 |
Total Medical Medicare Payment Amount |
24549.85 |
Total Medical Medicare Standardized Payment Amount |
24370.82 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
77 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
119 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
92 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.3494 |