National Provider Identifier [NPI]: |
1932369022 |
Last Name Of The Provider |
MARTIN |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
143 |
Number Of Services |
2442 |
Number Of Medicare Beneficiaries |
1279 |
Total Submitted Charge Amount |
309259.72 |
Total Medicare Allowed Amount |
82089.32 |
Total Medicare Payment Amount |
64173.77 |
Total Medicare Standardized Payment Amount |
65215.53 |
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 |
143 |
Number Of Medical Services |
2442 |
Number Of Medicare Beneficiaries With Medical Services |
1279 |
Total Medical Submitted Charge Amount |
309259.72 |
Total Medical Medicare Allowed Amount |
82089.32 |
Total Medical Medicare Payment Amount |
64173.77 |
Total Medical Medicare Standardized Payment Amount |
65215.53 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
291 |
Number Of Beneficiaries Age 65 to 74 |
344 |
Number Of Beneficiaries Age 75 to 84 |
370 |
Number Of Beneficiaries Age Greater 84 |
274 |
Number Of Female Beneficiaries |
862 |
Number Of Male Beneficiaries |
417 |
Number Of Non Hispanic White Beneficiaries |
864 |
Number Of Black or African American Beneficiaries |
267 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
128 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
842 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
437 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0279 |