National Provider Identifier [NPI]: |
1821083379 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12222 MERIT DR |
Street Address 2 Of The Provider |
SUITE 1420 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752512217 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1646 |
Number Of Medicare Beneficiaries |
802 |
Total Submitted Charge Amount |
457945 |
Total Medicare Allowed Amount |
205783.33 |
Total Medicare Payment Amount |
142835.17 |
Total Medicare Standardized Payment Amount |
143567.83 |
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 |
14 |
Number Of Medical Services |
1646 |
Number Of Medicare Beneficiaries With Medical Services |
802 |
Total Medical Submitted Charge Amount |
457945 |
Total Medical Medicare Allowed Amount |
205783.33 |
Total Medical Medicare Payment Amount |
142835.17 |
Total Medical Medicare Standardized Payment Amount |
143567.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
396 |
Number Of Beneficiaries Age 75 to 84 |
305 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
470 |
Number Of Male Beneficiaries |
332 |
Number Of Non Hispanic White Beneficiaries |
743 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8782 |