National Provider Identifier [NPI]: |
1073582458 |
Last Name Of The Provider |
DEV |
First Name Of The Provider |
RONY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 HOLCOMBE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770304009 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
403 |
Number Of Medicare Beneficiaries |
227 |
Total Submitted Charge Amount |
140617 |
Total Medicare Allowed Amount |
46946.41 |
Total Medicare Payment Amount |
36117.54 |
Total Medicare Standardized Payment Amount |
37274.5 |
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 |
10 |
Number Of Medical Services |
403 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
140617 |
Total Medical Medicare Allowed Amount |
46946.41 |
Total Medical Medicare Payment Amount |
36117.54 |
Total Medical Medicare Standardized Payment Amount |
37274.5 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
156 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
182 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
56 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.1757 |