National Provider Identifier [NPI]: |
1902896863 |
Last Name Of The Provider |
MCKINLEY |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1814 ROSELAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757014234 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
2452 |
Number Of Medicare Beneficiaries |
1076 |
Total Submitted Charge Amount |
261698 |
Total Medicare Allowed Amount |
146796.22 |
Total Medicare Payment Amount |
111379.77 |
Total Medicare Standardized Payment Amount |
115365.81 |
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 |
24 |
Number Of Medical Services |
2452 |
Number Of Medicare Beneficiaries With Medical Services |
1076 |
Total Medical Submitted Charge Amount |
261698 |
Total Medical Medicare Allowed Amount |
146796.22 |
Total Medical Medicare Payment Amount |
111379.77 |
Total Medical Medicare Standardized Payment Amount |
115365.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
156 |
Number Of Beneficiaries Age 65 to 74 |
550 |
Number Of Beneficiaries Age 75 to 84 |
305 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
632 |
Number Of Male Beneficiaries |
444 |
Number Of Non Hispanic White Beneficiaries |
985 |
Number Of Black or African American Beneficiaries |
61 |
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 |
937 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0725 |