National Provider Identifier [NPI]: |
1316903982 |
Last Name Of The Provider |
MACHA |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E DAWSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757012036 |
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 |
246 |
Number Of Services |
7332 |
Number Of Medicare Beneficiaries |
5139 |
Total Submitted Charge Amount |
1062739 |
Total Medicare Allowed Amount |
283889.2 |
Total Medicare Payment Amount |
214720.56 |
Total Medicare Standardized Payment Amount |
226683.12 |
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 |
246 |
Number Of Medical Services |
7332 |
Number Of Medicare Beneficiaries With Medical Services |
5139 |
Total Medical Submitted Charge Amount |
1062739 |
Total Medical Medicare Allowed Amount |
283889.2 |
Total Medical Medicare Payment Amount |
214720.56 |
Total Medical Medicare Standardized Payment Amount |
226683.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
909 |
Number Of Beneficiaries Age 65 to 74 |
1934 |
Number Of Beneficiaries Age 75 to 84 |
1533 |
Number Of Beneficiaries Age Greater 84 |
763 |
Number Of Female Beneficiaries |
2868 |
Number Of Male Beneficiaries |
2271 |
Number Of Non Hispanic White Beneficiaries |
4320 |
Number Of Black or African American Beneficiaries |
634 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
137 |
Number Of American Indian Alaska Native Beneficiaries |
11 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
3877 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1262 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6982 |