National Provider Identifier [NPI]: |
1851595359 |
Last Name Of The Provider |
FIGUEROA |
First Name Of The Provider |
IVAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14902 PRESTON RD |
Street Address 2 Of The Provider |
STE 404-1051 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752546801 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
5115 |
Number Of Medicare Beneficiaries |
621 |
Total Submitted Charge Amount |
558575 |
Total Medicare Allowed Amount |
325219.11 |
Total Medicare Payment Amount |
254025.12 |
Total Medicare Standardized Payment Amount |
262263.98 |
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 |
16 |
Number Of Medical Services |
5115 |
Number Of Medicare Beneficiaries With Medical Services |
621 |
Total Medical Submitted Charge Amount |
558575 |
Total Medical Medicare Allowed Amount |
325219.11 |
Total Medical Medicare Payment Amount |
254025.12 |
Total Medical Medicare Standardized Payment Amount |
262263.98 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
220 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
389 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
533 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
546 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
1.8882 |