National Provider Identifier [NPI]: |
1134144132 |
Last Name Of The Provider |
GICHERU |
First Name Of The Provider |
EUGENE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
426 OLD FM 548 |
Street Address 2 Of The Provider |
SUITE 124 |
City Of The Provider |
FORNEY |
Zip Code Of The Provider |
75126 |
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 |
24 |
Number Of Services |
371 |
Number Of Medicare Beneficiaries |
307 |
Total Submitted Charge Amount |
369931 |
Total Medicare Allowed Amount |
47120.99 |
Total Medicare Payment Amount |
34871.55 |
Total Medicare Standardized Payment Amount |
34921.33 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
127 |
Number Of Black or African American Beneficiaries |
136 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
158 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4026 |