National Provider Identifier [NPI]: |
1093714388 |
Last Name Of The Provider |
LE |
First Name Of The Provider |
TRUC |
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 |
3003 S LOOP W |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770541301 |
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 |
66 |
Number Of Services |
2832 |
Number Of Medicare Beneficiaries |
547 |
Total Submitted Charge Amount |
573003 |
Total Medicare Allowed Amount |
264498.09 |
Total Medicare Payment Amount |
201750.1 |
Total Medicare Standardized Payment Amount |
207723.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
115 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
3180 |
Total Drug Medicare AllowedAmount |
1481.02 |
Total Drug Medicare PaymentAmount |
1437.28 |
Total Drug Medicare Standardized Payment Amount |
1437.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
2717 |
Number Of Medicare Beneficiaries With Medical Services |
547 |
Total Medical Submitted Charge Amount |
569823 |
Total Medical Medicare Allowed Amount |
263017.07 |
Total Medical Medicare Payment Amount |
200312.82 |
Total Medical Medicare Standardized Payment Amount |
206286.14 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
317 |
Number Of Male Beneficiaries |
230 |
Number Of Non Hispanic White Beneficiaries |
301 |
Number Of Black or African American Beneficiaries |
140 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
340 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.7806 |