National Provider Identifier [NPI]: |
1194710012 |
Last Name Of The Provider |
DELAUNE |
First Name Of The Provider |
REX |
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 |
1190 E NINE MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PENSACOLA |
Zip Code Of The Provider |
325141651 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
6545 |
Number Of Medicare Beneficiaries |
458 |
Total Submitted Charge Amount |
527360 |
Total Medicare Allowed Amount |
212435.45 |
Total Medicare Payment Amount |
152381.44 |
Total Medicare Standardized Payment Amount |
155240.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
83 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
4299 |
Total Drug Medicare AllowedAmount |
1592.45 |
Total Drug Medicare PaymentAmount |
1522.83 |
Total Drug Medicare Standardized Payment Amount |
1522.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
6462 |
Number Of Medicare Beneficiaries With Medical Services |
458 |
Total Medical Submitted Charge Amount |
523061 |
Total Medical Medicare Allowed Amount |
210843 |
Total Medical Medicare Payment Amount |
150858.61 |
Total Medical Medicare Standardized Payment Amount |
153717.46 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
231 |
Number Of Non Hispanic White Beneficiaries |
424 |
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 |
427 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.994 |