National Provider Identifier [NPI]: |
1134280209 |
Last Name Of The Provider |
RHEA |
First Name Of The Provider |
DALTON |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
703 MCKINNEY AVE |
Street Address 2 Of The Provider |
SUITE 433 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752021007 |
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 |
24 |
Number Of Services |
1360 |
Number Of Medicare Beneficiaries |
534 |
Total Submitted Charge Amount |
120911 |
Total Medicare Allowed Amount |
119898.06 |
Total Medicare Payment Amount |
85730.19 |
Total Medicare Standardized Payment Amount |
87078.32 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
313 |
Number Of Black or African American Beneficiaries |
156 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
262 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.5392 |