National Provider Identifier [NPI]: |
1952359119 |
Last Name Of The Provider |
THOMPSON |
First Name Of The Provider |
BUDDY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3901 W 15TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLANO |
Zip Code Of The Provider |
75075 |
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 |
173 |
Number Of Services |
4448 |
Number Of Medicare Beneficiaries |
2587 |
Total Submitted Charge Amount |
645663.26 |
Total Medicare Allowed Amount |
137467.08 |
Total Medicare Payment Amount |
103161.01 |
Total Medicare Standardized Payment Amount |
108042.29 |
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 |
173 |
Number Of Medical Services |
4448 |
Number Of Medicare Beneficiaries With Medical Services |
2587 |
Total Medical Submitted Charge Amount |
645663.26 |
Total Medical Medicare Allowed Amount |
137467.08 |
Total Medical Medicare Payment Amount |
103161.01 |
Total Medical Medicare Standardized Payment Amount |
108042.29 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
445 |
Number Of Beneficiaries Age 65 to 74 |
911 |
Number Of Beneficiaries Age 75 to 84 |
796 |
Number Of Beneficiaries Age Greater 84 |
435 |
Number Of Female Beneficiaries |
1498 |
Number Of Male Beneficiaries |
1089 |
Number Of Non Hispanic White Beneficiaries |
2150 |
Number Of Black or African American Beneficiaries |
201 |
Number Of AsianPacific Islander Beneficiaries |
68 |
Number Of Hispanic Beneficiaries |
134 |
Number Of American Indian Alaska Native Beneficiaries |
11 |
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
1956 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
631 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0552 |