National Provider Identifier [NPI]: |
1578558987 |
Last Name Of The Provider |
HECTOR |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
619 S FLEISHEL AVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757012004 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
106 |
Number Of Services |
7726 |
Number Of Medicare Beneficiaries |
1641 |
Total Submitted Charge Amount |
1883949.47 |
Total Medicare Allowed Amount |
543509.62 |
Total Medicare Payment Amount |
412866.35 |
Total Medicare Standardized Payment Amount |
433640 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
2630 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
62813.52 |
Total Drug Medicare AllowedAmount |
23520.73 |
Total Drug Medicare PaymentAmount |
18273.72 |
Total Drug Medicare Standardized Payment Amount |
18273.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
101 |
Number Of Medical Services |
5096 |
Number Of Medicare Beneficiaries With Medical Services |
1641 |
Total Medical Submitted Charge Amount |
1821135.95 |
Total Medical Medicare Allowed Amount |
519988.89 |
Total Medical Medicare Payment Amount |
394592.63 |
Total Medical Medicare Standardized Payment Amount |
415366.28 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
584 |
Number Of Beneficiaries Age 75 to 84 |
607 |
Number Of Beneficiaries Age Greater 84 |
292 |
Number Of Female Beneficiaries |
818 |
Number Of Male Beneficiaries |
823 |
Number Of Non Hispanic White Beneficiaries |
1365 |
Number Of Black or African American Beneficiaries |
204 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
307 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.6155 |