National Provider Identifier [NPI]: |
1952398562 |
Last Name Of The Provider |
LI |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6400 FANNIN ST |
Street Address 2 Of The Provider |
STE 3000 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770301527 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
7316 |
Number Of Medicare Beneficiaries |
979 |
Total Submitted Charge Amount |
1555373.5 |
Total Medicare Allowed Amount |
458321.73 |
Total Medicare Payment Amount |
342993.84 |
Total Medicare Standardized Payment Amount |
346132.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
3209 |
Number Of Medicare Beneficiaries With Drug Services |
136 |
Total Drug Submitted ChargeAmount |
67061.25 |
Total Drug Medicare AllowedAmount |
28242.62 |
Total Drug Medicare PaymentAmount |
21881.51 |
Total Drug Medicare Standardized Payment Amount |
21881.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
4107 |
Number Of Medicare Beneficiaries With Medical Services |
979 |
Total Medical Submitted Charge Amount |
1488312.25 |
Total Medical Medicare Allowed Amount |
430079.11 |
Total Medical Medicare Payment Amount |
321112.33 |
Total Medical Medicare Standardized Payment Amount |
324250.93 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
373 |
Number Of Beneficiaries Age 75 to 84 |
322 |
Number Of Beneficiaries Age Greater 84 |
186 |
Number Of Female Beneficiaries |
526 |
Number Of Male Beneficiaries |
453 |
Number Of Non Hispanic White Beneficiaries |
638 |
Number Of Black or African American Beneficiaries |
174 |
Number Of AsianPacific Islander Beneficiaries |
61 |
Number Of Hispanic Beneficiaries |
95 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
820 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.1814 |