National Provider Identifier [NPI]: |
1891757654 |
Last Name Of The Provider |
DAY |
First Name Of The Provider |
MILES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4515 MARSHA SHARP FWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUBBOCK |
Zip Code Of The Provider |
794072520 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
1466 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
338990.09 |
Total Medicare Allowed Amount |
123879.65 |
Total Medicare Payment Amount |
87921.92 |
Total Medicare Standardized Payment Amount |
90711.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
99 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
1446.32 |
Total Drug Medicare AllowedAmount |
285.07 |
Total Drug Medicare PaymentAmount |
210.93 |
Total Drug Medicare Standardized Payment Amount |
210.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
1367 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
337543.77 |
Total Medical Medicare Allowed Amount |
123594.58 |
Total Medical Medicare Payment Amount |
87710.99 |
Total Medical Medicare Standardized Payment Amount |
90500.78 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
204 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
54 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
192 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3207 |