National Provider Identifier [NPI]: |
1316919038 |
Last Name Of The Provider |
NERO |
First Name Of The Provider |
LOURY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11888 MARSH LN |
Street Address 2 Of The Provider |
#104 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752348083 |
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 |
56 |
Number Of Services |
1074 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
134596.2 |
Total Medicare Allowed Amount |
58804.78 |
Total Medicare Payment Amount |
38764.65 |
Total Medicare Standardized Payment Amount |
39142.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
157 |
Number Of Medicare Beneficiaries With Drug Services |
39 |
Total Drug Submitted ChargeAmount |
1934 |
Total Drug Medicare AllowedAmount |
399.87 |
Total Drug Medicare PaymentAmount |
321.81 |
Total Drug Medicare Standardized Payment Amount |
321.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
917 |
Number Of Medicare Beneficiaries With Medical Services |
437 |
Total Medical Submitted Charge Amount |
132662.2 |
Total Medical Medicare Allowed Amount |
58404.91 |
Total Medical Medicare Payment Amount |
38442.84 |
Total Medical Medicare Standardized Payment Amount |
38820.65 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
333 |
Number Of Black or African American Beneficiaries |
61 |
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 |
391 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0366 |