National Provider Identifier [NPI]: |
1205817020 |
Last Name Of The Provider |
DENT |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1726 MEDICAL BLVD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341101426 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
2551 |
Number Of Medicare Beneficiaries |
624 |
Total Submitted Charge Amount |
338495 |
Total Medicare Allowed Amount |
163572.89 |
Total Medicare Payment Amount |
126319.98 |
Total Medicare Standardized Payment Amount |
123099.64 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
366 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
624 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
588 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
599 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8325 |