National Provider Identifier [NPI]: |
1891766739 |
Last Name Of The Provider |
NUKES |
First Name Of The Provider |
THEODORE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1185 W CARMEL DR |
Street Address 2 Of The Provider |
STE D-3 |
City Of The Provider |
CARMEL |
Zip Code Of The Provider |
460328708 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
1763 |
Number Of Medicare Beneficiaries |
462 |
Total Submitted Charge Amount |
454283.41 |
Total Medicare Allowed Amount |
190375.08 |
Total Medicare Payment Amount |
144369.18 |
Total Medicare Standardized Payment Amount |
151048.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
500 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
39166.41 |
Total Drug Medicare AllowedAmount |
34134.82 |
Total Drug Medicare PaymentAmount |
26415.93 |
Total Drug Medicare Standardized Payment Amount |
26415.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
1263 |
Number Of Medicare Beneficiaries With Medical Services |
462 |
Total Medical Submitted Charge Amount |
415117 |
Total Medical Medicare Allowed Amount |
156240.26 |
Total Medical Medicare Payment Amount |
117953.25 |
Total Medical Medicare Standardized Payment Amount |
124632.84 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
438 |
Number Of Black or African American Beneficiaries |
13 |
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 |
354 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.3326 |