National Provider Identifier [NPI]: |
1700914132 |
Last Name Of The Provider |
MADISON |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2700 TRIMMIER RD |
Street Address 2 Of The Provider |
APT.5207 |
City Of The Provider |
KILLEEN |
Zip Code Of The Provider |
765426000 |
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 |
115 |
Number Of Services |
1896 |
Number Of Medicare Beneficiaries |
737 |
Total Submitted Charge Amount |
129985 |
Total Medicare Allowed Amount |
40935.21 |
Total Medicare Payment Amount |
31874.66 |
Total Medicare Standardized Payment Amount |
33970.07 |
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 |
115 |
Number Of Medical Services |
1896 |
Number Of Medicare Beneficiaries With Medical Services |
737 |
Total Medical Submitted Charge Amount |
129985 |
Total Medical Medicare Allowed Amount |
40935.21 |
Total Medical Medicare Payment Amount |
31874.66 |
Total Medical Medicare Standardized Payment Amount |
33970.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
297 |
Number Of Beneficiaries Age 75 to 84 |
228 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
489 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
559 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1896 |