National Provider Identifier [NPI]: |
1619954757 |
Last Name Of The Provider |
DUNAL |
First Name Of The Provider |
JUDY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1221 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH WEYMOUTH |
Zip Code Of The Provider |
021901561 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
1542 |
Number Of Medicare Beneficiaries |
285 |
Total Submitted Charge Amount |
245325 |
Total Medicare Allowed Amount |
119946.39 |
Total Medicare Payment Amount |
90720.11 |
Total Medicare Standardized Payment Amount |
85040.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
138 |
Number Of Medicare Beneficiaries With Drug Services |
101 |
Total Drug Submitted ChargeAmount |
5871 |
Total Drug Medicare AllowedAmount |
4038.94 |
Total Drug Medicare PaymentAmount |
3931.3 |
Total Drug Medicare Standardized Payment Amount |
3931.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1404 |
Number Of Medicare Beneficiaries With Medical Services |
285 |
Total Medical Submitted Charge Amount |
239454 |
Total Medical Medicare Allowed Amount |
115907.45 |
Total Medical Medicare Payment Amount |
86788.81 |
Total Medical Medicare Standardized Payment Amount |
81109.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
266 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9677 |