National Provider Identifier [NPI]: |
1285695924 |
Last Name Of The Provider |
RICHMOND |
First Name Of The Provider |
KIM |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5001 SPRING VALLEY RD |
Street Address 2 Of The Provider |
SUITE 400 EAST |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752443946 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
199 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
328584 |
Total Medicare Allowed Amount |
50264.33 |
Total Medicare Payment Amount |
38561.6 |
Total Medicare Standardized Payment Amount |
40092.13 |
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 |
48 |
Number Of Medical Services |
199 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
328584 |
Total Medical Medicare Allowed Amount |
50264.33 |
Total Medical Medicare Payment Amount |
38561.6 |
Total Medical Medicare Standardized Payment Amount |
40092.13 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
61 |
Number Of Non Hispanic White Beneficiaries |
112 |
Number Of Black or African American Beneficiaries |
17 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
3.5097 |