National Provider Identifier [NPI]: |
1124290077 |
Last Name Of The Provider |
DEKAM |
First Name Of The Provider |
MEGAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4501 S 70TH ST STE 130 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685164276 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
7330 |
Number Of Medicare Beneficiaries |
333 |
Total Submitted Charge Amount |
382128 |
Total Medicare Allowed Amount |
193697.6 |
Total Medicare Payment Amount |
150736.33 |
Total Medicare Standardized Payment Amount |
162958.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
191 |
Number Of Medicare Beneficiaries With Drug Services |
106 |
Total Drug Submitted ChargeAmount |
7380 |
Total Drug Medicare AllowedAmount |
4294.12 |
Total Drug Medicare PaymentAmount |
4145.79 |
Total Drug Medicare Standardized Payment Amount |
4145.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
7139 |
Number Of Medicare Beneficiaries With Medical Services |
333 |
Total Medical Submitted Charge Amount |
374748 |
Total Medical Medicare Allowed Amount |
189403.48 |
Total Medical Medicare Payment Amount |
146590.54 |
Total Medical Medicare Standardized Payment Amount |
158813.06 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
237 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
311 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1266 |