National Provider Identifier [NPI]: |
1982904033 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
JOSHUA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2606 HOSPITAL BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784051804 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1147 |
Number Of Medicare Beneficiaries |
924 |
Total Submitted Charge Amount |
1475436 |
Total Medicare Allowed Amount |
153884.36 |
Total Medicare Payment Amount |
117535.73 |
Total Medicare Standardized Payment Amount |
120899.21 |
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 |
30 |
Number Of Medical Services |
1147 |
Number Of Medicare Beneficiaries With Medical Services |
924 |
Total Medical Submitted Charge Amount |
1475436 |
Total Medical Medicare Allowed Amount |
153884.36 |
Total Medical Medicare Payment Amount |
117535.73 |
Total Medical Medicare Standardized Payment Amount |
120899.21 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
261 |
Number Of Beneficiaries Age 65 to 74 |
259 |
Number Of Beneficiaries Age 75 to 84 |
231 |
Number Of Beneficiaries Age Greater 84 |
173 |
Number Of Female Beneficiaries |
508 |
Number Of Male Beneficiaries |
416 |
Number Of Non Hispanic White Beneficiaries |
681 |
Number Of Black or African American Beneficiaries |
202 |
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 |
531 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
393 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0455 |