National Provider Identifier [NPI]: |
1831104991 |
Last Name Of The Provider |
IRVIN |
First Name Of The Provider |
BRYAN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
940 HESTERS CROSSING |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROUND ROCK |
Zip Code Of The Provider |
786818018 |
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 |
84 |
Number Of Services |
841 |
Number Of Medicare Beneficiaries |
175 |
Total Submitted Charge Amount |
62404 |
Total Medicare Allowed Amount |
32207.52 |
Total Medicare Payment Amount |
22382.08 |
Total Medicare Standardized Payment Amount |
24774.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1993 |
Total Drug Medicare AllowedAmount |
1068.74 |
Total Drug Medicare PaymentAmount |
1013.91 |
Total Drug Medicare Standardized Payment Amount |
1013.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
796 |
Number Of Medicare Beneficiaries With Medical Services |
175 |
Total Medical Submitted Charge Amount |
60411 |
Total Medical Medicare Allowed Amount |
31138.78 |
Total Medical Medicare Payment Amount |
21368.17 |
Total Medical Medicare Standardized Payment Amount |
23760.62 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9513 |