National Provider Identifier [NPI]: |
1477589489 |
Last Name Of The Provider |
SEGAL |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6757 ARAPAHO RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752484005 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
307 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
477755 |
Total Medicare Allowed Amount |
62640.77 |
Total Medicare Payment Amount |
48378.64 |
Total Medicare Standardized Payment Amount |
50179.83 |
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 |
22 |
Number Of Medical Services |
307 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
477755 |
Total Medical Medicare Allowed Amount |
62640.77 |
Total Medical Medicare Payment Amount |
48378.64 |
Total Medical Medicare Standardized Payment Amount |
50179.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.468 |