National Provider Identifier [NPI]: |
1306801238 |
Last Name Of The Provider |
SLOAN |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3409 WORTH ST |
Street Address 2 Of The Provider |
710 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752462029 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
346539 |
Number Of Medicare Beneficiaries |
895 |
Total Submitted Charge Amount |
7375457.55 |
Total Medicare Allowed Amount |
2746123.76 |
Total Medicare Payment Amount |
2120112.42 |
Total Medicare Standardized Payment Amount |
2121055.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
45 |
Number Of Drug Services |
340092 |
Number Of Medicare Beneficiaries With Drug Services |
354 |
Total Drug Submitted ChargeAmount |
5826154.55 |
Total Drug Medicare AllowedAmount |
2276314.84 |
Total Drug Medicare PaymentAmount |
1766705.7 |
Total Drug Medicare Standardized Payment Amount |
1766705.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
6447 |
Number Of Medicare Beneficiaries With Medical Services |
895 |
Total Medical Submitted Charge Amount |
1549303 |
Total Medical Medicare Allowed Amount |
469808.92 |
Total Medical Medicare Payment Amount |
353406.72 |
Total Medical Medicare Standardized Payment Amount |
354350.06 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
308 |
Number Of Beneficiaries Age 65 to 74 |
340 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
490 |
Number Of Male Beneficiaries |
405 |
Number Of Non Hispanic White Beneficiaries |
630 |
Number Of Black or African American Beneficiaries |
184 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
652 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.4707 |