National Provider Identifier [NPI]: |
1659395069 |
Last Name Of The Provider |
ROSS |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6624 FANNIN ST |
Street Address 2 Of The Provider |
SUITE 2450 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770302309 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1753 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
258015.74 |
Total Medicare Allowed Amount |
135083.65 |
Total Medicare Payment Amount |
99975.34 |
Total Medicare Standardized Payment Amount |
101967.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
212.5 |
Total Drug Medicare AllowedAmount |
3.39 |
Total Drug Medicare PaymentAmount |
2.3 |
Total Drug Medicare Standardized Payment Amount |
2.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
1728 |
Number Of Medicare Beneficiaries With Medical Services |
325 |
Total Medical Submitted Charge Amount |
257803.24 |
Total Medical Medicare Allowed Amount |
135080.26 |
Total Medical Medicare Payment Amount |
99973.04 |
Total Medical Medicare Standardized Payment Amount |
101965.06 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
202 |
Number Of Black or African American Beneficiaries |
72 |
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 |
271 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.7163 |