National Provider Identifier [NPI]: |
1245371392 |
Last Name Of The Provider |
DUNETZ |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4440 E WASHINGTON AVE STE 109 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891105793 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
2316 |
Number Of Medicare Beneficiaries |
244 |
Total Submitted Charge Amount |
225863.17 |
Total Medicare Allowed Amount |
141535.9 |
Total Medicare Payment Amount |
109684.99 |
Total Medicare Standardized Payment Amount |
108122.55 |
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 |
30 |
Number Of Medical Services |
2316 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
225863.17 |
Total Medical Medicare Allowed Amount |
141535.9 |
Total Medical Medicare Payment Amount |
109684.99 |
Total Medical Medicare Standardized Payment Amount |
108122.55 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
90 |
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
73 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6316 |