National Provider Identifier [NPI]: |
1164436994 |
Last Name Of The Provider |
DAY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
56 N PECOS RD |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890740698 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1209 |
Number Of Medicare Beneficiaries |
464 |
Total Submitted Charge Amount |
303148 |
Total Medicare Allowed Amount |
101545.2 |
Total Medicare Payment Amount |
71878.82 |
Total Medicare Standardized Payment Amount |
72773.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
65 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
1980 |
Total Drug Medicare AllowedAmount |
526.91 |
Total Drug Medicare PaymentAmount |
514.58 |
Total Drug Medicare Standardized Payment Amount |
514.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1144 |
Number Of Medicare Beneficiaries With Medical Services |
464 |
Total Medical Submitted Charge Amount |
301168 |
Total Medical Medicare Allowed Amount |
101018.29 |
Total Medical Medicare Payment Amount |
71364.24 |
Total Medical Medicare Standardized Payment Amount |
72258.49 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
234 |
Number Of Non Hispanic White Beneficiaries |
398 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
451 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0099 |