National Provider Identifier [NPI]: |
1386664373 |
Last Name Of The Provider |
VAUGHN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2001 N OREGON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799023320 |
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 |
198 |
Number Of Services |
4388 |
Number Of Medicare Beneficiaries |
2629 |
Total Submitted Charge Amount |
570547.12 |
Total Medicare Allowed Amount |
138395.98 |
Total Medicare Payment Amount |
103395.43 |
Total Medicare Standardized Payment Amount |
108295.48 |
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 |
198 |
Number Of Medical Services |
4388 |
Number Of Medicare Beneficiaries With Medical Services |
2629 |
Total Medical Submitted Charge Amount |
570547.12 |
Total Medical Medicare Allowed Amount |
138395.98 |
Total Medical Medicare Payment Amount |
103395.43 |
Total Medical Medicare Standardized Payment Amount |
108295.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
460 |
Number Of Beneficiaries Age 65 to 74 |
754 |
Number Of Beneficiaries Age 75 to 84 |
825 |
Number Of Beneficiaries Age Greater 84 |
590 |
Number Of Female Beneficiaries |
1623 |
Number Of Male Beneficiaries |
1006 |
Number Of Non Hispanic White Beneficiaries |
899 |
Number Of Black or African American Beneficiaries |
77 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
1608 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1520 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1109 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1885 |