National Provider Identifier [NPI]: |
1801075288 |
Last Name Of The Provider |
DUDLEY |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
MEDICAL CENTER BLVD |
Street Address 2 Of The Provider |
DEPARTMENT OF ANESTHESIOLOGY |
City Of The Provider |
WINSTON SALEM |
Zip Code Of The Provider |
271570001 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
651 |
Number Of Medicare Beneficiaries |
446 |
Total Submitted Charge Amount |
972041.6 |
Total Medicare Allowed Amount |
102879.28 |
Total Medicare Payment Amount |
79995.62 |
Total Medicare Standardized Payment Amount |
77903.56 |
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 |
85 |
Number Of Medical Services |
651 |
Number Of Medicare Beneficiaries With Medical Services |
446 |
Total Medical Submitted Charge Amount |
972041.6 |
Total Medical Medicare Allowed Amount |
102879.28 |
Total Medical Medicare Payment Amount |
79995.62 |
Total Medical Medicare Standardized Payment Amount |
77903.56 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
209 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
354 |
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
361 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6711 |