National Provider Identifier [NPI]: |
1841266640 |
Last Name Of The Provider |
KECK |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 W ILLINOIS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDLAND |
Zip Code Of The Provider |
797016407 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
209 |
Number Of Services |
3771 |
Number Of Medicare Beneficiaries |
2146 |
Total Submitted Charge Amount |
607326 |
Total Medicare Allowed Amount |
134180.76 |
Total Medicare Payment Amount |
101213.29 |
Total Medicare Standardized Payment Amount |
106373.05 |
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 |
209 |
Number Of Medical Services |
3771 |
Number Of Medicare Beneficiaries With Medical Services |
2146 |
Total Medical Submitted Charge Amount |
607326 |
Total Medical Medicare Allowed Amount |
134180.76 |
Total Medical Medicare Payment Amount |
101213.29 |
Total Medical Medicare Standardized Payment Amount |
106373.05 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
371 |
Number Of Beneficiaries Age 65 to 74 |
704 |
Number Of Beneficiaries Age 75 to 84 |
667 |
Number Of Beneficiaries Age Greater 84 |
404 |
Number Of Female Beneficiaries |
1269 |
Number Of Male Beneficiaries |
877 |
Number Of Non Hispanic White Beneficiaries |
1505 |
Number Of Black or African American Beneficiaries |
137 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
479 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
1604 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
542 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6891 |