National Provider Identifier [NPI]: |
1154342608 |
Last Name Of The Provider |
MAPLES |
First Name Of The Provider |
JUDITH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6100 HARRIS PARKWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761324101 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1706 |
Number Of Medicare Beneficiaries |
553 |
Total Submitted Charge Amount |
225932.15 |
Total Medicare Allowed Amount |
46012.97 |
Total Medicare Payment Amount |
35844.6 |
Total Medicare Standardized Payment Amount |
24643.71 |
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 |
33 |
Number Of Medical Services |
1706 |
Number Of Medicare Beneficiaries With Medical Services |
553 |
Total Medical Submitted Charge Amount |
225932.15 |
Total Medical Medicare Allowed Amount |
46012.97 |
Total Medical Medicare Payment Amount |
35844.6 |
Total Medical Medicare Standardized Payment Amount |
24643.71 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
266 |
Number Of Non Hispanic White Beneficiaries |
364 |
Number Of Black or African American Beneficiaries |
109 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
67 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
348 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6646 |