National Provider Identifier [NPI]: |
1477590842 |
Last Name Of The Provider |
KIA |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6410 FANNIN ST |
Street Address 2 Of The Provider |
1400 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770303000 |
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 |
149 |
Number Of Services |
1236 |
Number Of Medicare Beneficiaries |
557 |
Total Submitted Charge Amount |
622752 |
Total Medicare Allowed Amount |
359302.19 |
Total Medicare Payment Amount |
279657.97 |
Total Medicare Standardized Payment Amount |
292323.97 |
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 |
149 |
Number Of Medical Services |
1236 |
Number Of Medicare Beneficiaries With Medical Services |
557 |
Total Medical Submitted Charge Amount |
622752 |
Total Medical Medicare Allowed Amount |
359302.19 |
Total Medical Medicare Payment Amount |
279657.97 |
Total Medical Medicare Standardized Payment Amount |
292323.97 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
189 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
305 |
Number Of Male Beneficiaries |
252 |
Number Of Non Hispanic White Beneficiaries |
427 |
Number Of Black or African American Beneficiaries |
113 |
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 |
392 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.29 |