National Provider Identifier [NPI]: |
1508954744 |
Last Name Of The Provider |
PELEG |
First Name Of The Provider |
LEEOR |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18220 STATE HIGHWAY 249 |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770704347 |
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 |
55 |
Number Of Services |
1040 |
Number Of Medicare Beneficiaries |
808 |
Total Submitted Charge Amount |
1389785 |
Total Medicare Allowed Amount |
150290.98 |
Total Medicare Payment Amount |
116367.87 |
Total Medicare Standardized Payment Amount |
116225 |
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 |
55 |
Number Of Medical Services |
1040 |
Number Of Medicare Beneficiaries With Medical Services |
808 |
Total Medical Submitted Charge Amount |
1389785 |
Total Medical Medicare Allowed Amount |
150290.98 |
Total Medical Medicare Payment Amount |
116367.87 |
Total Medical Medicare Standardized Payment Amount |
116225 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
262 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
193 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
469 |
Number Of Male Beneficiaries |
339 |
Number Of Non Hispanic White Beneficiaries |
387 |
Number Of Black or African American Beneficiaries |
268 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
127 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
453 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
355 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.6074 |