| National Provider Identifier [NPI]: | 1972730034 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | DUSTIN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5210 N BELT HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT JOSEPH |
| Zip Code Of The Provider | 645061211 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 421 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 32871 |
| Total Medicare Allowed Amount | 20540.14 |
| Total Medicare Payment Amount | 13322 |
| Total Medicare Standardized Payment Amount | 14099.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1141 |
| Total Drug Medicare AllowedAmount | 496.52 |
| Total Drug Medicare PaymentAmount | 467.59 |
| Total Drug Medicare Standardized Payment Amount | 467.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 383 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 31730 |
| Total Medical Medicare Allowed Amount | 20043.62 |
| Total Medical Medicare Payment Amount | 12854.41 |
| Total Medical Medicare Standardized Payment Amount | 13632.25 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | 128 |
| 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 | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0913 |