National Provider Identifier [NPI]: |
1699721852 |
Last Name Of The Provider |
DIPPEL |
First Name Of The Provider |
RODERICK |
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 |
955 RIBAUT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEAUFORT |
Zip Code Of The Provider |
299025441 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
413 |
Number Of Medicare Beneficiaries |
302 |
Total Submitted Charge Amount |
259861 |
Total Medicare Allowed Amount |
68955.96 |
Total Medicare Payment Amount |
53420.79 |
Total Medicare Standardized Payment Amount |
51467.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
413 |
Number Of Medicare Beneficiaries With Medical Services |
302 |
Total Medical Submitted Charge Amount |
259861 |
Total Medical Medicare Allowed Amount |
68955.96 |
Total Medical Medicare Payment Amount |
53420.79 |
Total Medical Medicare Standardized Payment Amount |
51467.74 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
274 |
Number Of Black or African American Beneficiaries |
14 |
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 |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7372 |