National Provider Identifier [NPI]: |
1992741193 |
Last Name Of The Provider |
MALONE |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1450 HUGHES RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAPEVINE |
Zip Code Of The Provider |
760517359 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
3246 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
959800 |
Total Medicare Allowed Amount |
270378.37 |
Total Medicare Payment Amount |
211817.12 |
Total Medicare Standardized Payment Amount |
214109.64 |
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 |
4 |
Number Of Medical Services |
3246 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
959800 |
Total Medical Medicare Allowed Amount |
270378.37 |
Total Medical Medicare Payment Amount |
211817.12 |
Total Medical Medicare Standardized Payment Amount |
214109.64 |
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
170 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
172 |
Number Of Black or African American Beneficiaries |
44 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
58 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4579 |