National Provider Identifier [NPI]: |
1760693493 |
Last Name Of The Provider |
CARRIER |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21214 NORTHWEST FWY |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
CYPRESS |
Zip Code Of The Provider |
774293373 |
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 |
182 |
Number Of Services |
6235 |
Number Of Medicare Beneficiaries |
3055 |
Total Submitted Charge Amount |
771552.93 |
Total Medicare Allowed Amount |
177249 |
Total Medicare Payment Amount |
128115.26 |
Total Medicare Standardized Payment Amount |
129458.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1410 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
380 |
Total Drug Medicare AllowedAmount |
280.43 |
Total Drug Medicare PaymentAmount |
219.87 |
Total Drug Medicare Standardized Payment Amount |
219.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
180 |
Number Of Medical Services |
4825 |
Number Of Medicare Beneficiaries With Medical Services |
3055 |
Total Medical Submitted Charge Amount |
771172.93 |
Total Medical Medicare Allowed Amount |
176968.57 |
Total Medical Medicare Payment Amount |
127895.39 |
Total Medical Medicare Standardized Payment Amount |
129238.16 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
414 |
Number Of Beneficiaries Age 65 to 74 |
1194 |
Number Of Beneficiaries Age 75 to 84 |
923 |
Number Of Beneficiaries Age Greater 84 |
524 |
Number Of Female Beneficiaries |
1847 |
Number Of Male Beneficiaries |
1208 |
Number Of Non Hispanic White Beneficiaries |
2145 |
Number Of Black or African American Beneficiaries |
412 |
Number Of AsianPacific Islander Beneficiaries |
139 |
Number Of Hispanic Beneficiaries |
318 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2335 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
720 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.939 |