National Provider Identifier [NPI]: |
1194735787 |
Last Name Of The Provider |
OWEN |
First Name Of The Provider |
STUART |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 GASTON AVE |
Street Address 2 Of The Provider |
SUITE 1004 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752461800 |
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 |
41 |
Number Of Services |
2322 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
197873.66 |
Total Medicare Allowed Amount |
173062.63 |
Total Medicare Payment Amount |
132711.81 |
Total Medicare Standardized Payment Amount |
140163.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
258 |
Number Of Medicare Beneficiaries With Drug Services |
225 |
Total Drug Submitted ChargeAmount |
15828.88 |
Total Drug Medicare AllowedAmount |
15713.75 |
Total Drug Medicare PaymentAmount |
15168.59 |
Total Drug Medicare Standardized Payment Amount |
15168.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2064 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
182044.78 |
Total Medical Medicare Allowed Amount |
157348.88 |
Total Medical Medicare Payment Amount |
117543.22 |
Total Medical Medicare Standardized Payment Amount |
124995.26 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
187 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
264 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
429 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9865 |