National Provider Identifier [NPI]: |
1194936344 |
Last Name Of The Provider |
GRAVES |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5201 HARRY HINES BLVD |
Street Address 2 Of The Provider |
HOUSE STAFF & GME |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752357708 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
231 |
Number Of Medicare Beneficiaries |
210 |
Total Submitted Charge Amount |
285982 |
Total Medicare Allowed Amount |
58787.45 |
Total Medicare Payment Amount |
45528.43 |
Total Medicare Standardized Payment Amount |
44635.59 |
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 |
62 |
Number Of Medical Services |
231 |
Number Of Medicare Beneficiaries With Medical Services |
210 |
Total Medical Submitted Charge Amount |
285982 |
Total Medical Medicare Allowed Amount |
58787.45 |
Total Medical Medicare Payment Amount |
45528.43 |
Total Medical Medicare Standardized Payment Amount |
44635.59 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
151 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6495 |