National Provider Identifier [NPI]: |
1629058821 |
Last Name Of The Provider |
DORSCH |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4881 SUGAR MAPLE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454335529 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
838 |
Number Of Medicare Beneficiaries |
455 |
Total Submitted Charge Amount |
358194 |
Total Medicare Allowed Amount |
88721.9 |
Total Medicare Payment Amount |
68427.4 |
Total Medicare Standardized Payment Amount |
70239.01 |
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 |
29 |
Number Of Medical Services |
838 |
Number Of Medicare Beneficiaries With Medical Services |
455 |
Total Medical Submitted Charge Amount |
358194 |
Total Medical Medicare Allowed Amount |
88721.9 |
Total Medical Medicare Payment Amount |
68427.4 |
Total Medical Medicare Standardized Payment Amount |
70239.01 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
215 |
Number Of Black or African American Beneficiaries |
115 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
87 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
288 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.5784 |