National Provider Identifier [NPI]: |
1033179593 |
Last Name Of The Provider |
HOLLINGSWORTH |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 S 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPLE |
Zip Code Of The Provider |
765080001 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1359 |
Number Of Medicare Beneficiaries |
816 |
Total Submitted Charge Amount |
677366 |
Total Medicare Allowed Amount |
230459.94 |
Total Medicare Payment Amount |
169449.48 |
Total Medicare Standardized Payment Amount |
179848.71 |
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 |
24 |
Number Of Medical Services |
1359 |
Number Of Medicare Beneficiaries With Medical Services |
816 |
Total Medical Submitted Charge Amount |
677366 |
Total Medical Medicare Allowed Amount |
230459.94 |
Total Medical Medicare Payment Amount |
169449.48 |
Total Medical Medicare Standardized Payment Amount |
179848.71 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
287 |
Number Of Beneficiaries Age 75 to 84 |
365 |
Number Of Beneficiaries Age Greater 84 |
112 |
Number Of Female Beneficiaries |
499 |
Number Of Male Beneficiaries |
317 |
Number Of Non Hispanic White Beneficiaries |
698 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
735 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1505 |