National Provider Identifier [NPI]: |
1548205057 |
Last Name Of The Provider |
UHRHAMMER |
First Name Of The Provider |
DENNIS |
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 |
7938 W JEFFERSON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468044140 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
901 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
122183 |
Total Medicare Allowed Amount |
62456.97 |
Total Medicare Payment Amount |
41196.77 |
Total Medicare Standardized Payment Amount |
45276.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
9477 |
Total Drug Medicare AllowedAmount |
4176.5 |
Total Drug Medicare PaymentAmount |
4064.24 |
Total Drug Medicare Standardized Payment Amount |
4064.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
806 |
Number Of Medicare Beneficiaries With Medical Services |
275 |
Total Medical Submitted Charge Amount |
112706 |
Total Medical Medicare Allowed Amount |
58280.47 |
Total Medical Medicare Payment Amount |
37132.53 |
Total Medical Medicare Standardized Payment Amount |
41212.7 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0235 |