National Provider Identifier [NPI]: |
1962499947 |
Last Name Of The Provider |
VENTURA |
First Name Of The Provider |
GERARD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4848 NE STALLINGS DR |
Street Address 2 Of The Provider |
SUITE 207 |
City Of The Provider |
NACOGDOCHES |
Zip Code Of The Provider |
759651266 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
25355 |
Number Of Medicare Beneficiaries |
355 |
Total Submitted Charge Amount |
1007898 |
Total Medicare Allowed Amount |
465120.45 |
Total Medicare Payment Amount |
357564.4 |
Total Medicare Standardized Payment Amount |
364116.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
32 |
Number Of Drug Services |
22827 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
847673.22 |
Total Drug Medicare AllowedAmount |
307061.58 |
Total Drug Medicare PaymentAmount |
240726.43 |
Total Drug Medicare Standardized Payment Amount |
240726.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
2528 |
Number Of Medicare Beneficiaries With Medical Services |
355 |
Total Medical Submitted Charge Amount |
160224.78 |
Total Medical Medicare Allowed Amount |
158058.87 |
Total Medical Medicare Payment Amount |
116837.97 |
Total Medical Medicare Standardized Payment Amount |
123389.81 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
232 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
316 |
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 |
304 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
59 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.706 |