National Provider Identifier [NPI]: |
1154435329 |
Last Name Of The Provider |
LANGSTON |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761044917 |
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 |
20 |
Number Of Services |
564 |
Number Of Medicare Beneficiaries |
331 |
Total Submitted Charge Amount |
342070.5 |
Total Medicare Allowed Amount |
61326.3 |
Total Medicare Payment Amount |
45996.62 |
Total Medicare Standardized Payment Amount |
47389.23 |
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 |
20 |
Number Of Medical Services |
564 |
Number Of Medicare Beneficiaries With Medical Services |
331 |
Total Medical Submitted Charge Amount |
342070.5 |
Total Medical Medicare Allowed Amount |
61326.3 |
Total Medical Medicare Payment Amount |
45996.62 |
Total Medical Medicare Standardized Payment Amount |
47389.23 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
249 |
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 |
182 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2573 |