National Provider Identifier [NPI]: |
1396784625 |
Last Name Of The Provider |
MAGLINTE |
First Name Of The Provider |
DEAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 N SENATE BLVD |
Street Address 2 Of The Provider |
ROOM 1204A |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1989 |
Number Of Medicare Beneficiaries |
1217 |
Total Submitted Charge Amount |
174754 |
Total Medicare Allowed Amount |
55956.05 |
Total Medicare Payment Amount |
42767.7 |
Total Medicare Standardized Payment Amount |
44868.63 |
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 |
48 |
Number Of Medical Services |
1989 |
Number Of Medicare Beneficiaries With Medical Services |
1217 |
Total Medical Submitted Charge Amount |
174754 |
Total Medical Medicare Allowed Amount |
55956.05 |
Total Medical Medicare Payment Amount |
42767.7 |
Total Medical Medicare Standardized Payment Amount |
44868.63 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
412 |
Number Of Beneficiaries Age 65 to 74 |
399 |
Number Of Beneficiaries Age 75 to 84 |
294 |
Number Of Beneficiaries Age Greater 84 |
112 |
Number Of Female Beneficiaries |
619 |
Number Of Male Beneficiaries |
598 |
Number Of Non Hispanic White Beneficiaries |
1011 |
Number Of Black or African American Beneficiaries |
168 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
767 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
450 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4933 |