National Provider Identifier [NPI]: |
1336142827 |
Last Name Of The Provider |
DUGAN |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8111 S EMERSON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462378601 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
3775 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
970311 |
Total Medicare Allowed Amount |
280539.2 |
Total Medicare Payment Amount |
215782.08 |
Total Medicare Standardized Payment Amount |
213162.27 |
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 |
37 |
Number Of Medical Services |
3775 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
970311 |
Total Medical Medicare Allowed Amount |
280539.2 |
Total Medical Medicare Payment Amount |
215782.08 |
Total Medical Medicare Standardized Payment Amount |
213162.27 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
224 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
279 |
Number Of Male Beneficiaries |
249 |
Number Of Non Hispanic White Beneficiaries |
466 |
Number Of Black or African American Beneficiaries |
44 |
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 |
478 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
73 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6615 |