National Provider Identifier [NPI]: |
1215929278 |
Last Name Of The Provider |
BUNTING |
First Name Of The Provider |
DARRIN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1725 COLUMBUS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANDUSKY |
Zip Code Of The Provider |
448703546 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1724 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
193081 |
Total Medicare Allowed Amount |
155309.32 |
Total Medicare Payment Amount |
115779.16 |
Total Medicare Standardized Payment Amount |
120859.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
96 |
Number Of Medicare Beneficiaries With Drug Services |
61 |
Total Drug Submitted ChargeAmount |
2808 |
Total Drug Medicare AllowedAmount |
1235.12 |
Total Drug Medicare PaymentAmount |
1183.64 |
Total Drug Medicare Standardized Payment Amount |
1183.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1628 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
190273 |
Total Medical Medicare Allowed Amount |
154074.2 |
Total Medical Medicare Payment Amount |
114595.52 |
Total Medical Medicare Standardized Payment Amount |
119675.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
298 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4047 |