National Provider Identifier [NPI]: |
1891783403 |
Last Name Of The Provider |
DEWEY |
First Name Of The Provider |
TODD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7777 FOREST LN |
Street Address 2 Of The Provider |
A323 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752302505 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Thoracic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
601 |
Number Of Medicare Beneficiaries |
279 |
Total Submitted Charge Amount |
1601693.5 |
Total Medicare Allowed Amount |
423428.95 |
Total Medicare Payment Amount |
329725.93 |
Total Medicare Standardized Payment Amount |
337828.54 |
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 |
65 |
Number Of Medical Services |
601 |
Number Of Medicare Beneficiaries With Medical Services |
279 |
Total Medical Submitted Charge Amount |
1601693.5 |
Total Medical Medicare Allowed Amount |
423428.95 |
Total Medical Medicare Payment Amount |
329725.93 |
Total Medical Medicare Standardized Payment Amount |
337828.54 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
223 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
72 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1304 |