National Provider Identifier [NPI]: |
1083667554 |
Last Name Of The Provider |
WESTERGAARD |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MDPA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9301 N. CENTRAL EXPRESSWAY |
Street Address 2 Of The Provider |
SUITE 115 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752310806 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1093 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
275115 |
Total Medicare Allowed Amount |
91646.39 |
Total Medicare Payment Amount |
66427.41 |
Total Medicare Standardized Payment Amount |
69165.7 |
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 |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
161 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9443 |