National Provider Identifier [NPI]: |
1730165218 |
Last Name Of The Provider |
BUNT |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400B HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARRENTON |
Zip Code Of The Provider |
201863026 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
513 |
Number Of Medicare Beneficiaries |
182 |
Total Submitted Charge Amount |
40803.64 |
Total Medicare Allowed Amount |
37284.61 |
Total Medicare Payment Amount |
24895.08 |
Total Medicare Standardized Payment Amount |
27861.98 |
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 |
25 |
Number Of Medical Services |
513 |
Number Of Medicare Beneficiaries With Medical Services |
182 |
Total Medical Submitted Charge Amount |
40803.64 |
Total Medical Medicare Allowed Amount |
37284.61 |
Total Medical Medicare Payment Amount |
24895.08 |
Total Medical Medicare Standardized Payment Amount |
27861.98 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
158 |
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3266 |