National Provider Identifier [NPI]: |
1265411789 |
Last Name Of The Provider |
REAGOR |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6800 N MACARTHUR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
IRVING |
Zip Code Of The Provider |
750392422 |
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 |
23 |
Number Of Services |
706 |
Number Of Medicare Beneficiaries |
379 |
Total Submitted Charge Amount |
358099 |
Total Medicare Allowed Amount |
68510.22 |
Total Medicare Payment Amount |
52174.56 |
Total Medicare Standardized Payment Amount |
52308.48 |
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 |
23 |
Number Of Medical Services |
706 |
Number Of Medicare Beneficiaries With Medical Services |
379 |
Total Medical Submitted Charge Amount |
358099 |
Total Medical Medicare Allowed Amount |
68510.22 |
Total Medical Medicare Payment Amount |
52174.56 |
Total Medical Medicare Standardized Payment Amount |
52308.48 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
240 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
253 |
Number Of Black or African American Beneficiaries |
63 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
262 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9896 |