National Provider Identifier [NPI]: |
1306811666 |
Last Name Of The Provider |
NEWTON |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 CENTRE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PETERSBURG |
Zip Code Of The Provider |
626759584 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
235 |
Number Of Medicare Beneficiaries |
163 |
Total Submitted Charge Amount |
40280 |
Total Medicare Allowed Amount |
14660.75 |
Total Medicare Payment Amount |
10193.82 |
Total Medicare Standardized Payment Amount |
10803.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
1439 |
Total Drug Medicare AllowedAmount |
203.13 |
Total Drug Medicare PaymentAmount |
128.76 |
Total Drug Medicare Standardized Payment Amount |
128.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
183 |
Number Of Medicare Beneficiaries With Medical Services |
163 |
Total Medical Submitted Charge Amount |
38841 |
Total Medical Medicare Allowed Amount |
14457.62 |
Total Medical Medicare Payment Amount |
10065.06 |
Total Medical Medicare Standardized Payment Amount |
10674.27 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
148 |
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 |
110 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1293 |