National Provider Identifier [NPI]: |
1366616203 |
Last Name Of The Provider |
FIELDS |
First Name Of The Provider |
ESTHER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 SCENIC DRIVE |
Street Address 2 Of The Provider |
SUITE 2208 |
City Of The Provider |
GEORGETOWN |
Zip Code Of The Provider |
786267703 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
4053 |
Number Of Medicare Beneficiaries |
952 |
Total Submitted Charge Amount |
890559.82 |
Total Medicare Allowed Amount |
285676.04 |
Total Medicare Payment Amount |
216460.25 |
Total Medicare Standardized Payment Amount |
230182.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
582.25 |
Total Drug Medicare AllowedAmount |
202.97 |
Total Drug Medicare PaymentAmount |
187.39 |
Total Drug Medicare Standardized Payment Amount |
187.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
4030 |
Number Of Medicare Beneficiaries With Medical Services |
952 |
Total Medical Submitted Charge Amount |
889977.57 |
Total Medical Medicare Allowed Amount |
285473.07 |
Total Medical Medicare Payment Amount |
216272.86 |
Total Medical Medicare Standardized Payment Amount |
229995.1 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
415 |
Number Of Beneficiaries Age 75 to 84 |
372 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
527 |
Number Of Male Beneficiaries |
425 |
Number Of Non Hispanic White Beneficiaries |
871 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
880 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
67 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6859 |