National Provider Identifier [NPI]: |
1851337737 |
Last Name Of The Provider |
GIMPEL |
First Name Of The Provider |
NORA |
Middle Initial Of The Provider |
E |
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 |
|
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 |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
287 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
58602 |
Total Medicare Allowed Amount |
16467.14 |
Total Medicare Payment Amount |
11710.64 |
Total Medicare Standardized Payment Amount |
11634.63 |
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 |
7 |
Number Of Medical Services |
287 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
58602 |
Total Medical Medicare Allowed Amount |
16467.14 |
Total Medical Medicare Payment Amount |
11710.64 |
Total Medical Medicare Standardized Payment Amount |
11634.63 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
33 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6434 |