Medicare Facts for Dr. Pridipongse S. Vithespongse, MD


National Provider Identifier [NPI]: 1144223470
Last Name Of The Provider VITHESPONGSE
First Name Of The Provider PRIDIPONGSE
Middle Initial Of The Provider
Credentials Of The Provider M.D.
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 103 W 2ND ST
Street Address 2 Of The Provider
City Of The Provider HEDRICK
Zip Code Of The Provider 525637769
State Code Of The Provider IA
Country Code Of The Provider US
Provider Type Of The Provider General Practice
Medicare Participation Indicator Y
Number Of HCPCS 26
Number Of Services 808
Number Of Medicare Beneficiaries 106
Total Submitted Charge Amount 66391
Total Medicare Allowed Amount 58393.02
Total Medicare Payment Amount 42929.96
Total Medicare Standardized Payment Amount 45947.97
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 7
Number Of Drug Services 85
Number Of Medicare Beneficiaries With Drug Services 44
Total Drug Submitted ChargeAmount 1798
Total Drug Medicare AllowedAmount 759.71
Total Drug Medicare PaymentAmount 686.65
Total Drug Medicare Standardized Payment Amount 686.65
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 19
Number Of Medical Services 723
Number Of Medicare Beneficiaries With Medical Services 106
Total Medical Submitted Charge Amount 64593
Total Medical Medicare Allowed Amount 57633.31
Total Medical Medicare Payment Amount 42243.31
Total Medical Medicare Standardized Payment Amount 45261.32
Average Age Of Beneficiaries 79
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84 38
Number Of Beneficiaries Age Greater 84 33
Number Of Female Beneficiaries 57
Number Of Male Beneficiaries 49
Number Of Non Hispanic White Beneficiaries
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries
Number Of Hispanic Beneficiaries
Number Of American Indian Alaska Native Beneficiaries
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement 74
Number Of Beneficiaries With Medicare Medicaid Entitlement 32
Percent Of With Atrial Fibrillation 12
Percent Of With Alzheimers Disease or Dementia 45
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure 48
Percent Of With Chronic Kidney Disease 15
Percent Of With Chronic Obstructive Pulmonary Disease 36
Percent Of With Depression 33
Percent Of With Diabetes 28
Percent Of With Hyperlipidemia 42
Percent Of With Hypertension 69
Percent Of With Ischemic Heart Disease 72
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 36
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke 11
Average HCC Risk Score Of Beneficiaries 1.4486

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