National Provider Identifier [NPI]: |
1366538472 |
Last Name Of The Provider |
DUPERRET |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 N TUCSON BLVD |
Street Address 2 Of The Provider |
#18 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
85716 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
3779 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
240404.7 |
Total Medicare Allowed Amount |
212995.29 |
Total Medicare Payment Amount |
158047.48 |
Total Medicare Standardized Payment Amount |
157808.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
248 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
11235 |
Total Drug Medicare AllowedAmount |
7101.22 |
Total Drug Medicare PaymentAmount |
6902.83 |
Total Drug Medicare Standardized Payment Amount |
6902.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
3531 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
229169.7 |
Total Medical Medicare Allowed Amount |
205894.07 |
Total Medical Medicare Payment Amount |
151144.65 |
Total Medical Medicare Standardized Payment Amount |
150905.97 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0137 |