National Provider Identifier [NPI]: |
1225088594 |
Last Name Of The Provider |
FOSTER |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1441 NORTH BECKLEY |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752031201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
2187 |
Number Of Medicare Beneficiaries |
630 |
Total Submitted Charge Amount |
392514 |
Total Medicare Allowed Amount |
78474.53 |
Total Medicare Payment Amount |
61268.08 |
Total Medicare Standardized Payment Amount |
50855.6 |
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 |
24 |
Number Of Medical Services |
2187 |
Number Of Medicare Beneficiaries With Medical Services |
630 |
Total Medical Submitted Charge Amount |
392514 |
Total Medical Medicare Allowed Amount |
78474.53 |
Total Medical Medicare Payment Amount |
61268.08 |
Total Medical Medicare Standardized Payment Amount |
50855.6 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
268 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
284 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
193 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
80 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
452 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2395 |