National Provider Identifier [NPI]: |
1053385971 |
Last Name Of The Provider |
DUDEE |
First Name Of The Provider |
JITANDER |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2351 HUGUENARD DRIVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
LEXINGTON |
Zip Code Of The Provider |
40503 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
1538 |
Number Of Medicare Beneficiaries |
229 |
Total Submitted Charge Amount |
370966 |
Total Medicare Allowed Amount |
184715.58 |
Total Medicare Payment Amount |
136451.09 |
Total Medicare Standardized Payment Amount |
144409.5 |
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 |
67 |
Number Of Medical Services |
1538 |
Number Of Medicare Beneficiaries With Medical Services |
229 |
Total Medical Submitted Charge Amount |
370966 |
Total Medical Medicare Allowed Amount |
184715.58 |
Total Medical Medicare Payment Amount |
136451.09 |
Total Medical Medicare Standardized Payment Amount |
144409.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
192 |
Number Of Black or African American Beneficiaries |
25 |
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 |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0529 |