National Provider Identifier [NPI]: |
1235336819 |
Last Name Of The Provider |
DAWKINS |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1801 SE HILLMOOR DR |
Street Address 2 Of The Provider |
SUITE B-109 |
City Of The Provider |
PORT SAINT LUCIE |
Zip Code Of The Provider |
349527553 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1937 |
Number Of Medicare Beneficiaries |
571 |
Total Submitted Charge Amount |
656632 |
Total Medicare Allowed Amount |
200756.3 |
Total Medicare Payment Amount |
157393.94 |
Total Medicare Standardized Payment Amount |
150588.33 |
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 |
27 |
Number Of Medical Services |
1937 |
Number Of Medicare Beneficiaries With Medical Services |
571 |
Total Medical Submitted Charge Amount |
656632 |
Total Medical Medicare Allowed Amount |
200756.3 |
Total Medical Medicare Payment Amount |
157393.94 |
Total Medical Medicare Standardized Payment Amount |
150588.33 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
175 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
284 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
450 |
Number Of Black or African American Beneficiaries |
64 |
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 |
404 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
167 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1468 |