National Provider Identifier [NPI]: |
1225243892 |
Last Name Of The Provider |
DORWART |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 SOUTH DR |
Street Address 2 Of The Provider |
FESLER HALL ROOM 204 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462025135 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2143 |
Number Of Medicare Beneficiaries |
446 |
Total Submitted Charge Amount |
859425.5 |
Total Medicare Allowed Amount |
173172.45 |
Total Medicare Payment Amount |
128620.96 |
Total Medicare Standardized Payment Amount |
134468.73 |
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 |
52 |
Number Of Medical Services |
2143 |
Number Of Medicare Beneficiaries With Medical Services |
446 |
Total Medical Submitted Charge Amount |
859425.5 |
Total Medical Medicare Allowed Amount |
173172.45 |
Total Medical Medicare Payment Amount |
128620.96 |
Total Medical Medicare Standardized Payment Amount |
134468.73 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
267 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
164 |
Number Of Non Hispanic White Beneficiaries |
370 |
Number Of Black or African American Beneficiaries |
61 |
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 |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
213 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9261 |