National Provider Identifier [NPI]: |
1629021498 |
Last Name Of The Provider |
GAMBLE |
First Name Of The Provider |
BRADFORD |
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 |
6300 W PARKER RD |
Street Address 2 Of The Provider |
STE 326 |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750938100 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
1222 |
Number Of Medicare Beneficiaries |
448 |
Total Submitted Charge Amount |
555551 |
Total Medicare Allowed Amount |
128016.7 |
Total Medicare Payment Amount |
94922.88 |
Total Medicare Standardized Payment Amount |
98896.85 |
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 |
76 |
Number Of Medical Services |
1222 |
Number Of Medicare Beneficiaries With Medical Services |
448 |
Total Medical Submitted Charge Amount |
555551 |
Total Medical Medicare Allowed Amount |
128016.7 |
Total Medical Medicare Payment Amount |
94922.88 |
Total Medical Medicare Standardized Payment Amount |
98896.85 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
397 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
416 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0849 |