National Provider Identifier [NPI]: |
1376538439 |
Last Name Of The Provider |
DEHORITY |
First Name Of The Provider |
DIXON |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 MATTHEWS TOWNSHIP PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MATTHEWS |
Zip Code Of The Provider |
281054656 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
459 |
Number Of Medicare Beneficiaries |
426 |
Total Submitted Charge Amount |
177179 |
Total Medicare Allowed Amount |
84359.4 |
Total Medicare Payment Amount |
64664.08 |
Total Medicare Standardized Payment Amount |
66993.21 |
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 |
20 |
Number Of Medical Services |
459 |
Number Of Medicare Beneficiaries With Medical Services |
426 |
Total Medical Submitted Charge Amount |
177179 |
Total Medical Medicare Allowed Amount |
84359.4 |
Total Medical Medicare Payment Amount |
64664.08 |
Total Medical Medicare Standardized Payment Amount |
66993.21 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
366 |
Number Of Black or African American Beneficiaries |
44 |
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 |
342 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9451 |