National Provider Identifier [NPI]: |
1043444565 |
Last Name Of The Provider |
KIRKWOOD |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
POB 1 SUITE 6.620 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907208 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
133 |
Number Of Services |
1417 |
Number Of Medicare Beneficiaries |
588 |
Total Submitted Charge Amount |
2403760 |
Total Medicare Allowed Amount |
287205.63 |
Total Medicare Payment Amount |
220383.28 |
Total Medicare Standardized Payment Amount |
222010.51 |
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 |
133 |
Number Of Medical Services |
1417 |
Number Of Medicare Beneficiaries With Medical Services |
588 |
Total Medical Submitted Charge Amount |
2403760 |
Total Medical Medicare Allowed Amount |
287205.63 |
Total Medical Medicare Payment Amount |
220383.28 |
Total Medical Medicare Standardized Payment Amount |
222010.51 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
276 |
Number Of Male Beneficiaries |
312 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
151 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
78 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
442 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
3.4405 |