National Provider Identifier [NPI]: |
1730176843 |
Last Name Of The Provider |
DUNN |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11900 N PENNSYLVANIA STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARMEL |
Zip Code Of The Provider |
460324694 |
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 |
120 |
Number Of Services |
6740 |
Number Of Medicare Beneficiaries |
1299 |
Total Submitted Charge Amount |
1270261.2 |
Total Medicare Allowed Amount |
184167.1 |
Total Medicare Payment Amount |
136252.17 |
Total Medicare Standardized Payment Amount |
150045.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
4924 |
Number Of Medicare Beneficiaries With Drug Services |
149 |
Total Drug Submitted ChargeAmount |
38013.2 |
Total Drug Medicare AllowedAmount |
2064.49 |
Total Drug Medicare PaymentAmount |
1588.24 |
Total Drug Medicare Standardized Payment Amount |
1588.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
110 |
Number Of Medical Services |
1816 |
Number Of Medicare Beneficiaries With Medical Services |
1299 |
Total Medical Submitted Charge Amount |
1232248 |
Total Medical Medicare Allowed Amount |
182102.61 |
Total Medical Medicare Payment Amount |
134663.93 |
Total Medical Medicare Standardized Payment Amount |
148457.21 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
244 |
Number Of Beneficiaries Age 65 to 74 |
693 |
Number Of Beneficiaries Age 75 to 84 |
294 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
799 |
Number Of Male Beneficiaries |
500 |
Number Of Non Hispanic White Beneficiaries |
1173 |
Number Of Black or African American Beneficiaries |
90 |
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 |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
1095 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
204 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0374 |