National Provider Identifier [NPI]: |
1346286192 |
Last Name Of The Provider |
DUMAS |
First Name Of The Provider |
NATASCHA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5568 WESLAYAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770051942 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
992 |
Number Of Medicare Beneficiaries |
89 |
Total Submitted Charge Amount |
272393 |
Total Medicare Allowed Amount |
89742.27 |
Total Medicare Payment Amount |
68470.9 |
Total Medicare Standardized Payment Amount |
68363.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
271 |
Number Of Medicare Beneficiaries With Drug Services |
64 |
Total Drug Submitted ChargeAmount |
72633 |
Total Drug Medicare AllowedAmount |
37367.13 |
Total Drug Medicare PaymentAmount |
28259.19 |
Total Drug Medicare Standardized Payment Amount |
28259.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
721 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
199760 |
Total Medical Medicare Allowed Amount |
52375.14 |
Total Medical Medicare Payment Amount |
40211.71 |
Total Medical Medicare Standardized Payment Amount |
40104.78 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
54 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0407 |