National Provider Identifier [NPI]: |
1306835442 |
Last Name Of The Provider |
MENDENHALL |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 E MARSHALL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LONGVIEW |
Zip Code Of The Provider |
756015580 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
2498 |
Number Of Medicare Beneficiaries |
1036 |
Total Submitted Charge Amount |
786244 |
Total Medicare Allowed Amount |
205203.57 |
Total Medicare Payment Amount |
154519.84 |
Total Medicare Standardized Payment Amount |
160658.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2498 |
Number Of Medicare Beneficiaries With Medical Services |
1036 |
Total Medical Submitted Charge Amount |
786244 |
Total Medical Medicare Allowed Amount |
205203.57 |
Total Medical Medicare Payment Amount |
154519.84 |
Total Medical Medicare Standardized Payment Amount |
160658.54 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
331 |
Number Of Beneficiaries Age 65 to 74 |
289 |
Number Of Beneficiaries Age 75 to 84 |
258 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
612 |
Number Of Male Beneficiaries |
424 |
Number Of Non Hispanic White Beneficiaries |
696 |
Number Of Black or African American Beneficiaries |
302 |
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 |
571 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
465 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2513 |