National Provider Identifier [NPI]: |
1487947180 |
Last Name Of The Provider |
WARREN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 ABRAHAM FLEXNER WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402022877 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
383 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
136409 |
Total Medicare Allowed Amount |
43542.87 |
Total Medicare Payment Amount |
33654.3 |
Total Medicare Standardized Payment Amount |
35742.77 |
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 |
15 |
Number Of Medical Services |
383 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
136409 |
Total Medical Medicare Allowed Amount |
43542.87 |
Total Medical Medicare Payment Amount |
33654.3 |
Total Medical Medicare Standardized Payment Amount |
35742.77 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
138 |
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 |
76 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4493 |