National Provider Identifier [NPI]: |
1063502912 |
Last Name Of The Provider |
GROGAN |
First Name Of The Provider |
WENDELL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22999 HIGHWAY 59 N STE 416 |
Street Address 2 Of The Provider |
|
City Of The Provider |
KINGWOOD |
Zip Code Of The Provider |
773394412 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
3226 |
Number Of Medicare Beneficiaries |
683 |
Total Submitted Charge Amount |
607862 |
Total Medicare Allowed Amount |
308423.6 |
Total Medicare Payment Amount |
232644.38 |
Total Medicare Standardized Payment Amount |
242827.36 |
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 |
22 |
Number Of Medical Services |
3226 |
Number Of Medicare Beneficiaries With Medical Services |
683 |
Total Medical Submitted Charge Amount |
607862 |
Total Medical Medicare Allowed Amount |
308423.6 |
Total Medical Medicare Payment Amount |
232644.38 |
Total Medical Medicare Standardized Payment Amount |
242827.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
274 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
377 |
Number Of Male Beneficiaries |
306 |
Number Of Non Hispanic White Beneficiaries |
546 |
Number Of Black or African American Beneficiaries |
80 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
555 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
31 |
Average HCC Risk Score Of Beneficiaries |
1.9554 |