National Provider Identifier [NPI]: |
1720237704 |
Last Name Of The Provider |
ANDRES |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVILLE |
Zip Code Of The Provider |
461221948 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1580 |
Number Of Medicare Beneficiaries |
633 |
Total Submitted Charge Amount |
288304 |
Total Medicare Allowed Amount |
165008.47 |
Total Medicare Payment Amount |
127464.34 |
Total Medicare Standardized Payment Amount |
134448.55 |
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 |
34 |
Number Of Medical Services |
1580 |
Number Of Medicare Beneficiaries With Medical Services |
633 |
Total Medical Submitted Charge Amount |
288304 |
Total Medical Medicare Allowed Amount |
165008.47 |
Total Medical Medicare Payment Amount |
127464.34 |
Total Medical Medicare Standardized Payment Amount |
134448.55 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
214 |
Number Of Beneficiaries Age Greater 84 |
176 |
Number Of Female Beneficiaries |
396 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
613 |
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 |
499 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8459 |