National Provider Identifier [NPI]: |
1710963368 |
Last Name Of The Provider |
ALTENAU |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7777 FOREST LN |
Street Address 2 Of The Provider |
SUITE B434 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752302505 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1198 |
Number Of Medicare Beneficiaries |
559 |
Total Submitted Charge Amount |
175490 |
Total Medicare Allowed Amount |
108829.16 |
Total Medicare Payment Amount |
76417.15 |
Total Medicare Standardized Payment Amount |
77918.25 |
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 |
31 |
Number Of Medical Services |
1198 |
Number Of Medicare Beneficiaries With Medical Services |
559 |
Total Medical Submitted Charge Amount |
175490 |
Total Medical Medicare Allowed Amount |
108829.16 |
Total Medical Medicare Payment Amount |
76417.15 |
Total Medical Medicare Standardized Payment Amount |
77918.25 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
169 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
321 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
450 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
458 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1329 |