National Provider Identifier [NPI]: |
1477557924 |
Last Name Of The Provider |
DIXON |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
440 ERNEST W BARRETT PKWY NW |
Street Address 2 Of The Provider |
STE 62 |
City Of The Provider |
KENNESAW |
Zip Code Of The Provider |
301444918 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
2115 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
209925 |
Total Medicare Allowed Amount |
120597.33 |
Total Medicare Payment Amount |
86411.87 |
Total Medicare Standardized Payment Amount |
86101.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
320 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1370 |
Total Drug Medicare AllowedAmount |
238.46 |
Total Drug Medicare PaymentAmount |
186.89 |
Total Drug Medicare Standardized Payment Amount |
186.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
1795 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
208555 |
Total Medical Medicare Allowed Amount |
120358.87 |
Total Medical Medicare Payment Amount |
86224.98 |
Total Medical Medicare Standardized Payment Amount |
85914.2 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
130 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
263 |
Number Of Black or African American Beneficiaries |
39 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
148 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7277 |