National Provider Identifier [NPI]: |
1053384172 |
Last Name Of The Provider |
DOTT |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11888 MARSH LN |
Street Address 2 Of The Provider |
#104 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752348083 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
994 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
90475 |
Total Medicare Allowed Amount |
37970.43 |
Total Medicare Payment Amount |
26563.75 |
Total Medicare Standardized Payment Amount |
26957.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
365 |
Number Of Medicare Beneficiaries With Drug Services |
71 |
Total Drug Submitted ChargeAmount |
3556 |
Total Drug Medicare AllowedAmount |
363.84 |
Total Drug Medicare PaymentAmount |
267.64 |
Total Drug Medicare Standardized Payment Amount |
267.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
629 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
86919 |
Total Medical Medicare Allowed Amount |
37606.59 |
Total Medical Medicare Payment Amount |
26296.11 |
Total Medical Medicare Standardized Payment Amount |
26690.25 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
226 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.933 |