National Provider Identifier [NPI]: |
1710936828 |
Last Name Of The Provider |
ATWELL |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
960 WEST WOOSTER ST |
Street Address 2 Of The Provider |
STE 108 |
City Of The Provider |
BOWLING GREEN |
Zip Code Of The Provider |
43402 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1456 |
Number Of Medicare Beneficiaries |
400 |
Total Submitted Charge Amount |
283084 |
Total Medicare Allowed Amount |
135369.98 |
Total Medicare Payment Amount |
103007.21 |
Total Medicare Standardized Payment Amount |
108800.94 |
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 |
22 |
Number Of Medical Services |
1456 |
Number Of Medicare Beneficiaries With Medical Services |
400 |
Total Medical Submitted Charge Amount |
283084 |
Total Medical Medicare Allowed Amount |
135369.98 |
Total Medical Medicare Payment Amount |
103007.21 |
Total Medical Medicare Standardized Payment Amount |
108800.94 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
372 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5693 |