National Provider Identifier [NPI]: |
1346246501 |
Last Name Of The Provider |
SCOTT |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1801 N SENATE BLVD |
Street Address 2 Of The Provider |
STE 610 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021228 |
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 |
75 |
Number Of Services |
1093 |
Number Of Medicare Beneficiaries |
543 |
Total Submitted Charge Amount |
550925.65 |
Total Medicare Allowed Amount |
106795.5 |
Total Medicare Payment Amount |
82894.87 |
Total Medicare Standardized Payment Amount |
85934.04 |
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 |
75 |
Number Of Medical Services |
1093 |
Number Of Medicare Beneficiaries With Medical Services |
543 |
Total Medical Submitted Charge Amount |
550925.65 |
Total Medical Medicare Allowed Amount |
106795.5 |
Total Medical Medicare Payment Amount |
82894.87 |
Total Medical Medicare Standardized Payment Amount |
85934.04 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
249 |
Number Of Non Hispanic White Beneficiaries |
451 |
Number Of Black or African American Beneficiaries |
78 |
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 |
381 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
39 |
Average HCC Risk Score Of Beneficiaries |
1.7519 |