National Provider Identifier [NPI]: |
1174813265 |
Last Name Of The Provider |
BILBO |
First Name Of The Provider |
COREY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5201 HARRY HINES BLVD |
Street Address 2 Of The Provider |
GRADUATE MEDICAL EDUCATION |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752357708 |
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 |
17 |
Number Of Services |
266 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
251906 |
Total Medicare Allowed Amount |
39788.01 |
Total Medicare Payment Amount |
30988.98 |
Total Medicare Standardized Payment Amount |
31219.54 |
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 |
17 |
Number Of Medical Services |
266 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
251906 |
Total Medical Medicare Allowed Amount |
39788.01 |
Total Medical Medicare Payment Amount |
30988.98 |
Total Medical Medicare Standardized Payment Amount |
31219.54 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
106 |
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 |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.1044 |