National Provider Identifier [NPI]: |
1811123169 |
Last Name Of The Provider |
LAW |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 N 1900 E |
Street Address 2 Of The Provider |
4C104 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841320002 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
916 |
Number Of Medicare Beneficiaries |
416 |
Total Submitted Charge Amount |
271994 |
Total Medicare Allowed Amount |
103058.06 |
Total Medicare Payment Amount |
79801.08 |
Total Medicare Standardized Payment Amount |
81494.68 |
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 |
40 |
Number Of Medical Services |
916 |
Number Of Medicare Beneficiaries With Medical Services |
416 |
Total Medical Submitted Charge Amount |
271994 |
Total Medical Medicare Allowed Amount |
103058.06 |
Total Medical Medicare Payment Amount |
79801.08 |
Total Medical Medicare Standardized Payment Amount |
81494.68 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
376 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9888 |