National Provider Identifier [NPI]: |
1124059027 |
Last Name Of The Provider |
GEORGE |
First Name Of The Provider |
LIBBY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
710 FM 1960 RD W |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770903402 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
305 |
Number Of Medicare Beneficiaries |
281 |
Total Submitted Charge Amount |
214792 |
Total Medicare Allowed Amount |
43964.39 |
Total Medicare Payment Amount |
33157.36 |
Total Medicare Standardized Payment Amount |
32943.06 |
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 |
21 |
Number Of Medical Services |
305 |
Number Of Medicare Beneficiaries With Medical Services |
281 |
Total Medical Submitted Charge Amount |
214792 |
Total Medical Medicare Allowed Amount |
43964.39 |
Total Medical Medicare Payment Amount |
33157.36 |
Total Medical Medicare Standardized Payment Amount |
32943.06 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
148 |
Number Of Black or African American Beneficiaries |
82 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.749 |