National Provider Identifier [NPI]: |
1447293402 |
Last Name Of The Provider |
DARR |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1210 PROVIDENT DRIVE |
Street Address 2 Of The Provider |
STE B |
City Of The Provider |
WARSAW |
Zip Code Of The Provider |
46580 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1832 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
149652 |
Total Medicare Allowed Amount |
72664.17 |
Total Medicare Payment Amount |
45061.77 |
Total Medicare Standardized Payment Amount |
49227.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
118 |
Number Of Medicare Beneficiaries With Drug Services |
84 |
Total Drug Submitted ChargeAmount |
4158 |
Total Drug Medicare AllowedAmount |
1695.04 |
Total Drug Medicare PaymentAmount |
1539.63 |
Total Drug Medicare Standardized Payment Amount |
1539.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
1714 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
145494 |
Total Medical Medicare Allowed Amount |
70969.13 |
Total Medical Medicare Payment Amount |
43522.14 |
Total Medical Medicare Standardized Payment Amount |
47688.08 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
326 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
|
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1749 |