National Provider Identifier [NPI]: |
1558399212 |
Last Name Of The Provider |
WARREN |
First Name Of The Provider |
BETH |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6124 W PARKER RD |
Street Address 2 Of The Provider |
SUITE 436 |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750938122 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
946 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
60679 |
Total Medicare Allowed Amount |
45167.73 |
Total Medicare Payment Amount |
29760.18 |
Total Medicare Standardized Payment Amount |
31431.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
185 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
4297 |
Total Drug Medicare AllowedAmount |
2873.1 |
Total Drug Medicare PaymentAmount |
2744.27 |
Total Drug Medicare Standardized Payment Amount |
2744.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
761 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
56382 |
Total Medical Medicare Allowed Amount |
42294.63 |
Total Medical Medicare Payment Amount |
27015.91 |
Total Medical Medicare Standardized Payment Amount |
28687.1 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
57 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.769 |