National Provider Identifier [NPI]: |
1669461380 |
Last Name Of The Provider |
DOUDNA |
First Name Of The Provider |
CARYN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1125 E SOUTHERN AVE |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852045045 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
4135 |
Number Of Medicare Beneficiaries |
1793 |
Total Submitted Charge Amount |
775046 |
Total Medicare Allowed Amount |
314528.22 |
Total Medicare Payment Amount |
275473.36 |
Total Medicare Standardized Payment Amount |
278588.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
480 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
2124 |
Total Drug Medicare AllowedAmount |
944.72 |
Total Drug Medicare PaymentAmount |
740.73 |
Total Drug Medicare Standardized Payment Amount |
740.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
3655 |
Number Of Medicare Beneficiaries With Medical Services |
1793 |
Total Medical Submitted Charge Amount |
772922 |
Total Medical Medicare Allowed Amount |
313583.5 |
Total Medical Medicare Payment Amount |
274732.63 |
Total Medical Medicare Standardized Payment Amount |
277847.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
1088 |
Number Of Beneficiaries Age 75 to 84 |
566 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
1778 |
Number Of Male Beneficiaries |
15 |
Number Of Non Hispanic White Beneficiaries |
1632 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
75 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1766 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.7992 |