National Provider Identifier [NPI]: |
1285796185 |
Last Name Of The Provider |
CUNNINGHAM |
First Name Of The Provider |
KEITH |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16620 N 40TH ST |
Street Address 2 Of The Provider |
H-5 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850323348 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
3297 |
Number Of Medicare Beneficiaries |
689 |
Total Submitted Charge Amount |
335277 |
Total Medicare Allowed Amount |
244874.75 |
Total Medicare Payment Amount |
182478.63 |
Total Medicare Standardized Payment Amount |
188245.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
477 |
Total Drug Medicare AllowedAmount |
257.57 |
Total Drug Medicare PaymentAmount |
244.99 |
Total Drug Medicare Standardized Payment Amount |
244.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
3280 |
Number Of Medicare Beneficiaries With Medical Services |
689 |
Total Medical Submitted Charge Amount |
334800 |
Total Medical Medicare Allowed Amount |
244617.18 |
Total Medical Medicare Payment Amount |
182233.64 |
Total Medical Medicare Standardized Payment Amount |
188000.33 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
270 |
Number Of Beneficiaries Age 75 to 84 |
244 |
Number Of Beneficiaries Age Greater 84 |
143 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
355 |
Number Of Non Hispanic White Beneficiaries |
652 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
658 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4211 |