National Provider Identifier [NPI]: |
1740490903 |
Last Name Of The Provider |
CARTER |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3500 GASTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752462017 |
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 |
21 |
Number Of Services |
1774 |
Number Of Medicare Beneficiaries |
1356 |
Total Submitted Charge Amount |
297369 |
Total Medicare Allowed Amount |
46277.4 |
Total Medicare Payment Amount |
33044.61 |
Total Medicare Standardized Payment Amount |
33789.04 |
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 |
21 |
Number Of Medical Services |
1774 |
Number Of Medicare Beneficiaries With Medical Services |
1356 |
Total Medical Submitted Charge Amount |
297369 |
Total Medical Medicare Allowed Amount |
46277.4 |
Total Medical Medicare Payment Amount |
33044.61 |
Total Medical Medicare Standardized Payment Amount |
33789.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
745 |
Number Of Beneficiaries Age 75 to 84 |
361 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
591 |
Number Of Male Beneficiaries |
765 |
Number Of Non Hispanic White Beneficiaries |
1042 |
Number Of Black or African American Beneficiaries |
122 |
Number Of AsianPacific Islander Beneficiaries |
36 |
Number Of Hispanic Beneficiaries |
125 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
42 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.5453 |