National Provider Identifier [NPI]: |
1881695930 |
Last Name Of The Provider |
PARK |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3333 COLORADO BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DENTON |
Zip Code Of The Provider |
762106817 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
4427 |
Number Of Medicare Beneficiaries |
768 |
Total Submitted Charge Amount |
1227543 |
Total Medicare Allowed Amount |
445650.29 |
Total Medicare Payment Amount |
325093.62 |
Total Medicare Standardized Payment Amount |
348129.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
340 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
54825 |
Total Drug Medicare AllowedAmount |
18004.77 |
Total Drug Medicare PaymentAmount |
12955.4 |
Total Drug Medicare Standardized Payment Amount |
12955.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
4087 |
Number Of Medicare Beneficiaries With Medical Services |
768 |
Total Medical Submitted Charge Amount |
1172718 |
Total Medical Medicare Allowed Amount |
427645.52 |
Total Medical Medicare Payment Amount |
312138.22 |
Total Medical Medicare Standardized Payment Amount |
335174.33 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
295 |
Number Of Beneficiaries Age 75 to 84 |
312 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
401 |
Number Of Non Hispanic White Beneficiaries |
733 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
731 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4027 |