National Provider Identifier [NPI]: |
1356480594 |
Last Name Of The Provider |
HOUSE |
First Name Of The Provider |
JANELLE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 BRAZOS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKDALE |
Zip Code Of The Provider |
765672517 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
1070 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
81894.5 |
Total Medicare Allowed Amount |
46235 |
Total Medicare Payment Amount |
32511.29 |
Total Medicare Standardized Payment Amount |
34603.83 |
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 |
10 |
Number Of Medical Services |
1070 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
81894.5 |
Total Medical Medicare Allowed Amount |
46235 |
Total Medical Medicare Payment Amount |
32511.29 |
Total Medical Medicare Standardized Payment Amount |
34603.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
83 |
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 |
206 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
154 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1781 |