National Provider Identifier [NPI]: |
1144378084 |
Last Name Of The Provider |
SCHUPP |
First Name Of The Provider |
CHRISTIAN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
508 MEDICAL CENTER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CONROE |
Zip Code Of The Provider |
773042808 |
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 |
46 |
Number Of Services |
506 |
Number Of Medicare Beneficiaries |
71 |
Total Submitted Charge Amount |
64424 |
Total Medicare Allowed Amount |
18585.45 |
Total Medicare Payment Amount |
13167.71 |
Total Medicare Standardized Payment Amount |
13095.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
193 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
3093 |
Total Drug Medicare AllowedAmount |
1072.94 |
Total Drug Medicare PaymentAmount |
850.55 |
Total Drug Medicare Standardized Payment Amount |
850.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
313 |
Number Of Medicare Beneficiaries With Medical Services |
71 |
Total Medical Submitted Charge Amount |
61331 |
Total Medical Medicare Allowed Amount |
17512.51 |
Total Medical Medicare Payment Amount |
12317.16 |
Total Medical Medicare Standardized Payment Amount |
12244.46 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
27 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
27 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4015 |