National Provider Identifier [NPI]: |
1164534426 |
Last Name Of The Provider |
OSAGIE |
First Name Of The Provider |
OWEN |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4910 AIRPORT AVE |
Street Address 2 Of The Provider |
BLDG A |
City Of The Provider |
ROSENBERG |
Zip Code Of The Provider |
774715759 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
889 |
Number Of Medicare Beneficiaries |
224 |
Total Submitted Charge Amount |
97525 |
Total Medicare Allowed Amount |
78631.77 |
Total Medicare Payment Amount |
52556.75 |
Total Medicare Standardized Payment Amount |
55526.66 |
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 |
6 |
Number Of Medical Services |
889 |
Number Of Medicare Beneficiaries With Medical Services |
224 |
Total Medical Submitted Charge Amount |
97525 |
Total Medical Medicare Allowed Amount |
78631.77 |
Total Medical Medicare Payment Amount |
52556.75 |
Total Medical Medicare Standardized Payment Amount |
55526.66 |
Average Age Of Beneficiaries |
51 |
Number Of Beneficiaries Age Less65 |
187 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
69 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
58 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
166 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
65 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
46 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1182 |