National Provider Identifier [NPI]: |
1821257072 |
Last Name Of The Provider |
PAULSON |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3410 WORTH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752462003 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
5853 |
Number Of Medicare Beneficiaries |
103 |
Total Submitted Charge Amount |
480266 |
Total Medicare Allowed Amount |
102273.35 |
Total Medicare Payment Amount |
80697.82 |
Total Medicare Standardized Payment Amount |
80407.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
29 |
Number Of Drug Services |
5020 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
281496 |
Total Drug Medicare AllowedAmount |
36699.37 |
Total Drug Medicare PaymentAmount |
28776.14 |
Total Drug Medicare Standardized Payment Amount |
28776.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
833 |
Number Of Medicare Beneficiaries With Medical Services |
103 |
Total Medical Submitted Charge Amount |
198770 |
Total Medical Medicare Allowed Amount |
65573.98 |
Total Medical Medicare Payment Amount |
51921.68 |
Total Medical Medicare Standardized Payment Amount |
51631.11 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
76 |
Number Of Black or African American Beneficiaries |
|
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 |
88 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
45 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6013 |