National Provider Identifier [NPI]: |
1114902517 |
Last Name Of The Provider |
SUTER |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3450 W WHEATLAND RD |
Street Address 2 Of The Provider |
PAV II STE#340 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752373470 |
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 |
59 |
Number Of Services |
893 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
93904.49 |
Total Medicare Allowed Amount |
58807.32 |
Total Medicare Payment Amount |
40869.49 |
Total Medicare Standardized Payment Amount |
41462.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
173 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
3404 |
Total Drug Medicare AllowedAmount |
2173.35 |
Total Drug Medicare PaymentAmount |
1988.1 |
Total Drug Medicare Standardized Payment Amount |
1988.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
720 |
Number Of Medicare Beneficiaries With Medical Services |
290 |
Total Medical Submitted Charge Amount |
90500.49 |
Total Medical Medicare Allowed Amount |
56633.97 |
Total Medical Medicare Payment Amount |
38881.39 |
Total Medical Medicare Standardized Payment Amount |
39473.94 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
113 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5006 |