National Provider Identifier [NPI]: |
1619973328 |
Last Name Of The Provider |
DUDLEY |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 S SEACREST BLVD |
Street Address 2 Of The Provider |
# 240 |
City Of The Provider |
BOYNTON BEACH |
Zip Code Of The Provider |
334357960 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
8474 |
Number Of Medicare Beneficiaries |
671 |
Total Submitted Charge Amount |
771509 |
Total Medicare Allowed Amount |
382807.34 |
Total Medicare Payment Amount |
290821.43 |
Total Medicare Standardized Payment Amount |
280966.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
1001 |
Number Of Medicare Beneficiaries With Drug Services |
369 |
Total Drug Submitted ChargeAmount |
24078 |
Total Drug Medicare AllowedAmount |
12259.46 |
Total Drug Medicare PaymentAmount |
11351.04 |
Total Drug Medicare Standardized Payment Amount |
11351.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
7473 |
Number Of Medicare Beneficiaries With Medical Services |
671 |
Total Medical Submitted Charge Amount |
747431 |
Total Medical Medicare Allowed Amount |
370547.88 |
Total Medical Medicare Payment Amount |
279470.39 |
Total Medical Medicare Standardized Payment Amount |
269615.26 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
211 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
383 |
Number Of Male Beneficiaries |
288 |
Number Of Non Hispanic White Beneficiaries |
614 |
Number Of Black or African American Beneficiaries |
23 |
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 |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
626 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0583 |