National Provider Identifier [NPI]: |
1861484974 |
Last Name Of The Provider |
HIRT |
First Name Of The Provider |
DARRELL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 W CANNON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761043029 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
3454 |
Number Of Medicare Beneficiaries |
492 |
Total Submitted Charge Amount |
3158008 |
Total Medicare Allowed Amount |
465681.39 |
Total Medicare Payment Amount |
356689.85 |
Total Medicare Standardized Payment Amount |
369579.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
814 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
162800 |
Total Drug Medicare AllowedAmount |
9322.06 |
Total Drug Medicare PaymentAmount |
6806.02 |
Total Drug Medicare Standardized Payment Amount |
6806.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
2640 |
Number Of Medicare Beneficiaries With Medical Services |
492 |
Total Medical Submitted Charge Amount |
2995208 |
Total Medical Medicare Allowed Amount |
456359.33 |
Total Medical Medicare Payment Amount |
349883.83 |
Total Medical Medicare Standardized Payment Amount |
362773.48 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
269 |
Number Of Non Hispanic White Beneficiaries |
376 |
Number Of Black or African American Beneficiaries |
61 |
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 |
360 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
4.4063 |