National Provider Identifier [NPI]: |
1710929377 |
Last Name Of The Provider |
DELAFIELD |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6400 DUTCHMANS PKWY |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402053340 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2177 |
Number Of Medicare Beneficiaries |
375 |
Total Submitted Charge Amount |
151108 |
Total Medicare Allowed Amount |
99739.13 |
Total Medicare Payment Amount |
67958.7 |
Total Medicare Standardized Payment Amount |
73784.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
130 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
4052 |
Total Drug Medicare AllowedAmount |
1962.28 |
Total Drug Medicare PaymentAmount |
1859.27 |
Total Drug Medicare Standardized Payment Amount |
1859.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
2047 |
Number Of Medicare Beneficiaries With Medical Services |
375 |
Total Medical Submitted Charge Amount |
147056 |
Total Medical Medicare Allowed Amount |
97776.85 |
Total Medical Medicare Payment Amount |
66099.43 |
Total Medical Medicare Standardized Payment Amount |
71925.67 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
350 |
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 |
333 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2777 |