National Provider Identifier [NPI]: |
1689650541 |
Last Name Of The Provider |
PARK |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3032 COMMUNICATIONS PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750938913 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
810 |
Number Of Medicare Beneficiaries |
372 |
Total Submitted Charge Amount |
334570.59 |
Total Medicare Allowed Amount |
113752.14 |
Total Medicare Payment Amount |
85593.04 |
Total Medicare Standardized Payment Amount |
91127.45 |
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 |
43 |
Number Of Medical Services |
810 |
Number Of Medicare Beneficiaries With Medical Services |
372 |
Total Medical Submitted Charge Amount |
334570.59 |
Total Medical Medicare Allowed Amount |
113752.14 |
Total Medical Medicare Payment Amount |
85593.04 |
Total Medical Medicare Standardized Payment Amount |
91127.45 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
164 |
Number Of Non Hispanic White Beneficiaries |
250 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
88 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1276 |