National Provider Identifier [NPI]: |
1790780625 |
Last Name Of The Provider |
DAYTON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD, PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 S LANDMARK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
474033239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
193 |
Number Of Services |
188121 |
Number Of Medicare Beneficiaries |
1012 |
Total Submitted Charge Amount |
9273698 |
Total Medicare Allowed Amount |
3830743.81 |
Total Medicare Payment Amount |
2961868.13 |
Total Medicare Standardized Payment Amount |
2978935.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
85 |
Number Of Drug Services |
173680 |
Number Of Medicare Beneficiaries With Drug Services |
557 |
Total Drug Submitted ChargeAmount |
7971612 |
Total Drug Medicare AllowedAmount |
3299523.43 |
Total Drug Medicare PaymentAmount |
2545869.6 |
Total Drug Medicare Standardized Payment Amount |
2545869.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
108 |
Number Of Medical Services |
14441 |
Number Of Medicare Beneficiaries With Medical Services |
1009 |
Total Medical Submitted Charge Amount |
1302086 |
Total Medical Medicare Allowed Amount |
531220.38 |
Total Medical Medicare Payment Amount |
415998.53 |
Total Medical Medicare Standardized Payment Amount |
433066.23 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
420 |
Number Of Beneficiaries Age 75 to 84 |
355 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
595 |
Number Of Male Beneficiaries |
417 |
Number Of Non Hispanic White Beneficiaries |
980 |
Number Of Black or African American Beneficiaries |
14 |
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 |
877 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
35 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.752 |