National Provider Identifier [NPI]: |
1215060041 |
Last Name Of The Provider |
DRISKILL |
First Name Of The Provider |
LANCE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3901 W 15TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750757738 |
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 |
186 |
Number Of Services |
1953 |
Number Of Medicare Beneficiaries |
1038 |
Total Submitted Charge Amount |
482690.66 |
Total Medicare Allowed Amount |
103236.31 |
Total Medicare Payment Amount |
79808.94 |
Total Medicare Standardized Payment Amount |
82189.21 |
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 |
186 |
Number Of Medical Services |
1953 |
Number Of Medicare Beneficiaries With Medical Services |
1038 |
Total Medical Submitted Charge Amount |
482690.66 |
Total Medical Medicare Allowed Amount |
103236.31 |
Total Medical Medicare Payment Amount |
79808.94 |
Total Medical Medicare Standardized Payment Amount |
82189.21 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
396 |
Number Of Beneficiaries Age 75 to 84 |
304 |
Number Of Beneficiaries Age Greater 84 |
184 |
Number Of Female Beneficiaries |
564 |
Number Of Male Beneficiaries |
474 |
Number Of Non Hispanic White Beneficiaries |
905 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
871 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
167 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.392 |