National Provider Identifier [NPI]: |
1417045303 |
Last Name Of The Provider |
SCARBOROUGH |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
508 MEDICAL CENTER BLVD |
Street Address 2 Of The Provider |
STE 350 |
City Of The Provider |
CONROE |
Zip Code Of The Provider |
773042808 |
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 |
86 |
Number Of Services |
5925 |
Number Of Medicare Beneficiaries |
717 |
Total Submitted Charge Amount |
788232.4 |
Total Medicare Allowed Amount |
246257.43 |
Total Medicare Payment Amount |
170549.9 |
Total Medicare Standardized Payment Amount |
181407.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
2219 |
Number Of Medicare Beneficiaries With Drug Services |
313 |
Total Drug Submitted ChargeAmount |
149287 |
Total Drug Medicare AllowedAmount |
7005.76 |
Total Drug Medicare PaymentAmount |
5215.31 |
Total Drug Medicare Standardized Payment Amount |
5215.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
3706 |
Number Of Medicare Beneficiaries With Medical Services |
717 |
Total Medical Submitted Charge Amount |
638945.4 |
Total Medical Medicare Allowed Amount |
239251.67 |
Total Medical Medicare Payment Amount |
165334.59 |
Total Medical Medicare Standardized Payment Amount |
176192.65 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
381 |
Number Of Beneficiaries Age 75 to 84 |
220 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
421 |
Number Of Male Beneficiaries |
296 |
Number Of Non Hispanic White Beneficiaries |
680 |
Number Of Black or African American Beneficiaries |
16 |
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 |
675 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.0199 |