National Provider Identifier [NPI]: |
1881697282 |
Last Name Of The Provider |
KAM |
First Name Of The Provider |
JEFFREY |
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 |
12700 PARK CENTRAL DR |
Street Address 2 Of The Provider |
STE 430 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752511527 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
3353 |
Number Of Medicare Beneficiaries |
2488 |
Total Submitted Charge Amount |
245199 |
Total Medicare Allowed Amount |
73261.19 |
Total Medicare Payment Amount |
56253.42 |
Total Medicare Standardized Payment Amount |
58019.07 |
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 |
102 |
Number Of Medical Services |
3353 |
Number Of Medicare Beneficiaries With Medical Services |
2488 |
Total Medical Submitted Charge Amount |
245199 |
Total Medical Medicare Allowed Amount |
73261.19 |
Total Medical Medicare Payment Amount |
56253.42 |
Total Medical Medicare Standardized Payment Amount |
58019.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
178 |
Number Of Beneficiaries Age 65 to 74 |
1162 |
Number Of Beneficiaries Age 75 to 84 |
833 |
Number Of Beneficiaries Age Greater 84 |
315 |
Number Of Female Beneficiaries |
1465 |
Number Of Male Beneficiaries |
1023 |
Number Of Non Hispanic White Beneficiaries |
2177 |
Number Of Black or African American Beneficiaries |
147 |
Number Of AsianPacific Islander Beneficiaries |
48 |
Number Of Hispanic Beneficiaries |
82 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2281 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.379 |