National Provider Identifier [NPI]: |
1730127903 |
Last Name Of The Provider |
HEASLEY |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8440 WALNUT HILL LN |
Street Address 2 Of The Provider |
SUITE 510 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752313833 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
3787 |
Number Of Medicare Beneficiaries |
1966 |
Total Submitted Charge Amount |
1190302 |
Total Medicare Allowed Amount |
232501.51 |
Total Medicare Payment Amount |
176880.91 |
Total Medicare Standardized Payment Amount |
180733.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
645 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
3510 |
Total Drug Medicare AllowedAmount |
779.35 |
Total Drug Medicare PaymentAmount |
571.91 |
Total Drug Medicare Standardized Payment Amount |
571.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
3142 |
Number Of Medicare Beneficiaries With Medical Services |
1966 |
Total Medical Submitted Charge Amount |
1186792 |
Total Medical Medicare Allowed Amount |
231722.16 |
Total Medical Medicare Payment Amount |
176309 |
Total Medical Medicare Standardized Payment Amount |
180161.27 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
227 |
Number Of Beneficiaries Age 65 to 74 |
708 |
Number Of Beneficiaries Age 75 to 84 |
644 |
Number Of Beneficiaries Age Greater 84 |
387 |
Number Of Female Beneficiaries |
1172 |
Number Of Male Beneficiaries |
794 |
Number Of Non Hispanic White Beneficiaries |
1718 |
Number Of Black or African American Beneficiaries |
135 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
80 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
1747 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
219 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
1.4491 |