National Provider Identifier [NPI]: |
1952344202 |
Last Name Of The Provider |
DELASHAW |
First Name Of The Provider |
MINI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12221 MERIT DR |
Street Address 2 Of The Provider |
SUITE 1610 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752512202 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1021 |
Number Of Medicare Beneficiaries |
548 |
Total Submitted Charge Amount |
511277 |
Total Medicare Allowed Amount |
102154.01 |
Total Medicare Payment Amount |
77042.11 |
Total Medicare Standardized Payment Amount |
77693.45 |
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 |
42 |
Number Of Medical Services |
1021 |
Number Of Medicare Beneficiaries With Medical Services |
548 |
Total Medical Submitted Charge Amount |
511277 |
Total Medical Medicare Allowed Amount |
102154.01 |
Total Medical Medicare Payment Amount |
77042.11 |
Total Medical Medicare Standardized Payment Amount |
77693.45 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
186 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
300 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
364 |
Number Of Black or African American Beneficiaries |
121 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.5774 |