National Provider Identifier [NPI]: |
1609964394 |
Last Name Of The Provider |
TUCKER |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6513 PRESTON RD |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750242688 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
115 |
Number Of Medicare Beneficiaries |
83 |
Total Submitted Charge Amount |
118915.53 |
Total Medicare Allowed Amount |
17057.38 |
Total Medicare Payment Amount |
13320.23 |
Total Medicare Standardized Payment Amount |
13916.15 |
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 |
26 |
Number Of Medical Services |
115 |
Number Of Medicare Beneficiaries With Medical Services |
83 |
Total Medical Submitted Charge Amount |
118915.53 |
Total Medical Medicare Allowed Amount |
17057.38 |
Total Medical Medicare Payment Amount |
13320.23 |
Total Medical Medicare Standardized Payment Amount |
13916.15 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
15 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8905 |