National Provider Identifier [NPI]: |
1588775241 |
Last Name Of The Provider |
DUVALL |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1755 S GRAND |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST LOUIS |
Zip Code Of The Provider |
63104 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
2800 |
Number Of Medicare Beneficiaries |
1013 |
Total Submitted Charge Amount |
166468.24 |
Total Medicare Allowed Amount |
163654.28 |
Total Medicare Payment Amount |
110586.01 |
Total Medicare Standardized Payment Amount |
155030.27 |
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 |
45 |
Number Of Medical Services |
2800 |
Number Of Medicare Beneficiaries With Medical Services |
1013 |
Total Medical Submitted Charge Amount |
166468.24 |
Total Medical Medicare Allowed Amount |
163654.28 |
Total Medical Medicare Payment Amount |
110586.01 |
Total Medical Medicare Standardized Payment Amount |
155030.27 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
522 |
Number Of Beneficiaries Age 75 to 84 |
327 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
508 |
Number Of Male Beneficiaries |
505 |
Number Of Non Hispanic White Beneficiaries |
972 |
Number Of Black or African American Beneficiaries |
17 |
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 |
988 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9528 |