National Provider Identifier [NPI]: |
1316937105 |
Last Name Of The Provider |
CARRIER |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12951 SOUTH FWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770471923 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
3275 |
Number Of Medicare Beneficiaries |
2412 |
Total Submitted Charge Amount |
995371 |
Total Medicare Allowed Amount |
183923.04 |
Total Medicare Payment Amount |
140532.3 |
Total Medicare Standardized Payment Amount |
143363.23 |
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 |
90 |
Number Of Medical Services |
3275 |
Number Of Medicare Beneficiaries With Medical Services |
2412 |
Total Medical Submitted Charge Amount |
995371 |
Total Medical Medicare Allowed Amount |
183923.04 |
Total Medical Medicare Payment Amount |
140532.3 |
Total Medical Medicare Standardized Payment Amount |
143363.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
347 |
Number Of Beneficiaries Age 65 to 74 |
822 |
Number Of Beneficiaries Age 75 to 84 |
782 |
Number Of Beneficiaries Age Greater 84 |
461 |
Number Of Female Beneficiaries |
1455 |
Number Of Male Beneficiaries |
957 |
Number Of Non Hispanic White Beneficiaries |
1585 |
Number Of Black or African American Beneficiaries |
448 |
Number Of AsianPacific Islander Beneficiaries |
115 |
Number Of Hispanic Beneficiaries |
230 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1920 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
492 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
28 |
Average HCC Risk Score Of Beneficiaries |
2.1412 |