National Provider Identifier [NPI]: |
1164429395 |
Last Name Of The Provider |
WEY |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
403 W CAMPBELL RD |
Street Address 2 Of The Provider |
STE 320 |
City Of The Provider |
RICHARDSON |
Zip Code Of The Provider |
750803466 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
1854.5 |
Number Of Medicare Beneficiaries |
131 |
Total Submitted Charge Amount |
271539 |
Total Medicare Allowed Amount |
74306.22 |
Total Medicare Payment Amount |
54499.62 |
Total Medicare Standardized Payment Amount |
56494.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1260.5 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
39315 |
Total Drug Medicare AllowedAmount |
15334.4 |
Total Drug Medicare PaymentAmount |
11855.12 |
Total Drug Medicare Standardized Payment Amount |
11855.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
594 |
Number Of Medicare Beneficiaries With Medical Services |
131 |
Total Medical Submitted Charge Amount |
232224 |
Total Medical Medicare Allowed Amount |
58971.82 |
Total Medical Medicare Payment Amount |
42644.5 |
Total Medical Medicare Standardized Payment Amount |
44639.03 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
104 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
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 |
120 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.0778 |