National Provider Identifier [NPI]: |
1417913609 |
Last Name Of The Provider |
CARR-LOCKE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD FRCP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10 UNION SQ E |
Street Address 2 Of The Provider |
SUITE 2G |
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100033314 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
379 |
Number Of Medicare Beneficiaries |
182 |
Total Submitted Charge Amount |
503715 |
Total Medicare Allowed Amount |
71365.02 |
Total Medicare Payment Amount |
54631.9 |
Total Medicare Standardized Payment Amount |
50220.71 |
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 |
45 |
Number Of Medical Services |
379 |
Number Of Medicare Beneficiaries With Medical Services |
182 |
Total Medical Submitted Charge Amount |
503715 |
Total Medical Medicare Allowed Amount |
71365.02 |
Total Medical Medicare Payment Amount |
54631.9 |
Total Medical Medicare Standardized Payment Amount |
50220.71 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
103 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
28 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.953 |