National Provider Identifier [NPI]: |
1750335774 |
Last Name Of The Provider |
DUVALL |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
416B 4TH AVENUE EAST |
Street Address 2 Of The Provider |
STE B |
City Of The Provider |
CORDELE |
Zip Code Of The Provider |
31015 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2993 |
Number Of Medicare Beneficiaries |
374 |
Total Submitted Charge Amount |
157896.03 |
Total Medicare Allowed Amount |
137529.97 |
Total Medicare Payment Amount |
94984.25 |
Total Medicare Standardized Payment Amount |
107022.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
90 |
Number Of Medicare Beneficiaries With Drug Services |
84 |
Total Drug Submitted ChargeAmount |
1897.67 |
Total Drug Medicare AllowedAmount |
1865.66 |
Total Drug Medicare PaymentAmount |
1740.74 |
Total Drug Medicare Standardized Payment Amount |
1740.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2903 |
Number Of Medicare Beneficiaries With Medical Services |
374 |
Total Medical Submitted Charge Amount |
155998.36 |
Total Medical Medicare Allowed Amount |
135664.31 |
Total Medical Medicare Payment Amount |
93243.51 |
Total Medical Medicare Standardized Payment Amount |
105281.52 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
332 |
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 |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2101 |