National Provider Identifier [NPI]: |
1538363130 |
Last Name Of The Provider |
VO |
First Name Of The Provider |
LE |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21214 NORTHWEST FREEWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
CYPRESS |
Zip Code Of The Provider |
77429 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
1232 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
360525 |
Total Medicare Allowed Amount |
130048.74 |
Total Medicare Payment Amount |
101270.69 |
Total Medicare Standardized Payment Amount |
101149.55 |
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 |
11 |
Number Of Medical Services |
1232 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
360525 |
Total Medical Medicare Allowed Amount |
130048.74 |
Total Medical Medicare Payment Amount |
101270.69 |
Total Medical Medicare Standardized Payment Amount |
101149.55 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
215 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
2.379 |