National Provider Identifier [NPI]: |
1437192481 |
Last Name Of The Provider |
DUMONTIER |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
901 PATIENTS FIRST DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WASHINGTON |
Zip Code Of The Provider |
630904700 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
3025 |
Number Of Medicare Beneficiaries |
458 |
Total Submitted Charge Amount |
350230 |
Total Medicare Allowed Amount |
207467.32 |
Total Medicare Payment Amount |
157415.68 |
Total Medicare Standardized Payment Amount |
170153.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
822 |
Number Of Medicare Beneficiaries With Drug Services |
230 |
Total Drug Submitted ChargeAmount |
31761 |
Total Drug Medicare AllowedAmount |
18839.62 |
Total Drug Medicare PaymentAmount |
17438.65 |
Total Drug Medicare Standardized Payment Amount |
17438.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
2203 |
Number Of Medicare Beneficiaries With Medical Services |
458 |
Total Medical Submitted Charge Amount |
318469 |
Total Medical Medicare Allowed Amount |
188627.7 |
Total Medical Medicare Payment Amount |
139977.03 |
Total Medical Medicare Standardized Payment Amount |
152714.44 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
188 |
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 |
425 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2085 |