National Provider Identifier [NPI]: |
1578507182 |
Last Name Of The Provider |
LAI |
First Name Of The Provider |
JENNY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6550 FANNIN ST |
Street Address 2 Of The Provider |
SMITH TOWER, SUITE 2501 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770302717 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
66606 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
2093148 |
Total Medicare Allowed Amount |
626763.82 |
Total Medicare Payment Amount |
466393.1 |
Total Medicare Standardized Payment Amount |
476795.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
64982 |
Number Of Medicare Beneficiaries With Drug Services |
110 |
Total Drug Submitted ChargeAmount |
1513862 |
Total Drug Medicare AllowedAmount |
467167.16 |
Total Drug Medicare PaymentAmount |
354371.73 |
Total Drug Medicare Standardized Payment Amount |
354371.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1624 |
Number Of Medicare Beneficiaries With Medical Services |
397 |
Total Medical Submitted Charge Amount |
579286 |
Total Medical Medicare Allowed Amount |
159596.66 |
Total Medical Medicare Payment Amount |
112021.37 |
Total Medical Medicare Standardized Payment Amount |
122423.91 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
276 |
Number Of Black or African American Beneficiaries |
69 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
33 |
Average HCC Risk Score Of Beneficiaries |
2.3769 |