National Provider Identifier [NPI]: |
1780704445 |
Last Name Of The Provider |
BAILEY |
First Name Of The Provider |
DEAN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
950 W WOOSTER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOWLING GREEN |
Zip Code Of The Provider |
434022603 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
836 |
Number Of Medicare Beneficiaries |
276 |
Total Submitted Charge Amount |
162448 |
Total Medicare Allowed Amount |
111933.6 |
Total Medicare Payment Amount |
86739.83 |
Total Medicare Standardized Payment Amount |
88189.01 |
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 |
18 |
Number Of Medical Services |
836 |
Number Of Medicare Beneficiaries With Medical Services |
276 |
Total Medical Submitted Charge Amount |
162448 |
Total Medical Medicare Allowed Amount |
111933.6 |
Total Medical Medicare Payment Amount |
86739.83 |
Total Medical Medicare Standardized Payment Amount |
88189.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
258 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0104 |