National Provider Identifier [NPI]: |
1720041056 |
Last Name Of The Provider |
SEYMOUR |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22710 PROFESSIONAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
KINGWOOD |
Zip Code Of The Provider |
773396008 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
145 |
Number Of Services |
199000 |
Number Of Medicare Beneficiaries |
464 |
Total Submitted Charge Amount |
7658070.76 |
Total Medicare Allowed Amount |
3164297.09 |
Total Medicare Payment Amount |
2457326.75 |
Total Medicare Standardized Payment Amount |
2449759.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
70 |
Number Of Drug Services |
192020 |
Number Of Medicare Beneficiaries With Drug Services |
209 |
Total Drug Submitted ChargeAmount |
5891035.39 |
Total Drug Medicare AllowedAmount |
2480468.35 |
Total Drug Medicare PaymentAmount |
1935026.59 |
Total Drug Medicare Standardized Payment Amount |
1935026.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
6980 |
Number Of Medicare Beneficiaries With Medical Services |
463 |
Total Medical Submitted Charge Amount |
1767035.37 |
Total Medical Medicare Allowed Amount |
683828.74 |
Total Medical Medicare Payment Amount |
522300.16 |
Total Medical Medicare Standardized Payment Amount |
514732.81 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
278 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
397 |
Number Of Black or African American Beneficiaries |
35 |
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 |
418 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
46 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0342 |