National Provider Identifier [NPI]: |
1598872673 |
Last Name Of The Provider |
WEBB |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1633 N CAPITOL AVE |
Street Address 2 Of The Provider |
SUITE 680 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021261 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
526 |
Number Of Medicare Beneficiaries |
98 |
Total Submitted Charge Amount |
56145 |
Total Medicare Allowed Amount |
43178.8 |
Total Medicare Payment Amount |
33553.97 |
Total Medicare Standardized Payment Amount |
34860.94 |
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 |
5 |
Number Of Medical Services |
526 |
Number Of Medicare Beneficiaries With Medical Services |
98 |
Total Medical Submitted Charge Amount |
56145 |
Total Medical Medicare Allowed Amount |
43178.8 |
Total Medical Medicare Payment Amount |
33553.97 |
Total Medical Medicare Standardized Payment Amount |
34860.94 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
22 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
63 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
3.0255 |