National Provider Identifier [NPI]: |
1891943023 |
Last Name Of The Provider |
SIVAK |
First Name Of The Provider |
NATALIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 S 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPLE |
Zip Code Of The Provider |
765080001 |
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 |
130 |
Number Of Services |
3364 |
Number Of Medicare Beneficiaries |
2436 |
Total Submitted Charge Amount |
449363 |
Total Medicare Allowed Amount |
97573.79 |
Total Medicare Payment Amount |
71069.08 |
Total Medicare Standardized Payment Amount |
74357.74 |
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 |
130 |
Number Of Medical Services |
3364 |
Number Of Medicare Beneficiaries With Medical Services |
2436 |
Total Medical Submitted Charge Amount |
449363 |
Total Medical Medicare Allowed Amount |
97573.79 |
Total Medical Medicare Payment Amount |
71069.08 |
Total Medical Medicare Standardized Payment Amount |
74357.74 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
639 |
Number Of Beneficiaries Age 65 to 74 |
882 |
Number Of Beneficiaries Age 75 to 84 |
620 |
Number Of Beneficiaries Age Greater 84 |
295 |
Number Of Female Beneficiaries |
1376 |
Number Of Male Beneficiaries |
1060 |
Number Of Non Hispanic White Beneficiaries |
1778 |
Number Of Black or African American Beneficiaries |
347 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
257 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1731 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
705 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.946 |