National Provider Identifier [NPI]: |
1366465999 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2730 S VAL VISTA DR |
Street Address 2 Of The Provider |
SUITE 187 |
City Of The Provider |
GILBERT |
Zip Code Of The Provider |
852966675 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
3423 |
Number Of Medicare Beneficiaries |
1025 |
Total Submitted Charge Amount |
422445 |
Total Medicare Allowed Amount |
304545.08 |
Total Medicare Payment Amount |
222346.7 |
Total Medicare Standardized Payment Amount |
224395.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
201 |
Number Of Medicare Beneficiaries With Drug Services |
95 |
Total Drug Submitted ChargeAmount |
4102 |
Total Drug Medicare AllowedAmount |
2800.98 |
Total Drug Medicare PaymentAmount |
2677.12 |
Total Drug Medicare Standardized Payment Amount |
2677.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
3222 |
Number Of Medicare Beneficiaries With Medical Services |
1023 |
Total Medical Submitted Charge Amount |
418343 |
Total Medical Medicare Allowed Amount |
301744.1 |
Total Medical Medicare Payment Amount |
219669.58 |
Total Medical Medicare Standardized Payment Amount |
221718.6 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
463 |
Number Of Beneficiaries Age 75 to 84 |
353 |
Number Of Beneficiaries Age Greater 84 |
181 |
Number Of Female Beneficiaries |
525 |
Number Of Male Beneficiaries |
500 |
Number Of Non Hispanic White Beneficiaries |
966 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
1009 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9504 |