National Provider Identifier [NPI]: |
1932130242 |
Last Name Of The Provider |
TOTTEN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
630 BROADWAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
472503310 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
3245 |
Number Of Medicare Beneficiaries |
471 |
Total Submitted Charge Amount |
517655.9 |
Total Medicare Allowed Amount |
216726.73 |
Total Medicare Payment Amount |
157862.11 |
Total Medicare Standardized Payment Amount |
166614.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
142 |
Number Of Medicare Beneficiaries With Drug Services |
53 |
Total Drug Submitted ChargeAmount |
2461 |
Total Drug Medicare AllowedAmount |
650 |
Total Drug Medicare PaymentAmount |
619.29 |
Total Drug Medicare Standardized Payment Amount |
619.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
93 |
Number Of Medical Services |
3103 |
Number Of Medicare Beneficiaries With Medical Services |
471 |
Total Medical Submitted Charge Amount |
515194.9 |
Total Medical Medicare Allowed Amount |
216076.73 |
Total Medical Medicare Payment Amount |
157242.82 |
Total Medical Medicare Standardized Payment Amount |
165994.91 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
459 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7473 |