National Provider Identifier [NPI]: |
1770511222 |
Last Name Of The Provider |
GATES |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6250 HWY. 83-84 AT ANTILLEY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ABILENE |
Zip Code Of The Provider |
796065299 |
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 |
22 |
Number Of Services |
946 |
Number Of Medicare Beneficiaries |
575 |
Total Submitted Charge Amount |
1016197 |
Total Medicare Allowed Amount |
102164.08 |
Total Medicare Payment Amount |
78497.02 |
Total Medicare Standardized Payment Amount |
80608.54 |
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 |
22 |
Number Of Medical Services |
946 |
Number Of Medicare Beneficiaries With Medical Services |
575 |
Total Medical Submitted Charge Amount |
1016197 |
Total Medical Medicare Allowed Amount |
102164.08 |
Total Medical Medicare Payment Amount |
78497.02 |
Total Medical Medicare Standardized Payment Amount |
80608.54 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
322 |
Number Of Male Beneficiaries |
253 |
Number Of Non Hispanic White Beneficiaries |
497 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
417 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7296 |