National Provider Identifier [NPI]: |
1275526550 |
Last Name Of The Provider |
GIDLEY |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 HOLCOMBE BLVD |
Street Address 2 Of The Provider |
441 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770304009 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
938 |
Number Of Medicare Beneficiaries |
372 |
Total Submitted Charge Amount |
653355 |
Total Medicare Allowed Amount |
117513.54 |
Total Medicare Payment Amount |
88924.14 |
Total Medicare Standardized Payment Amount |
89850.23 |
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 |
38 |
Number Of Medical Services |
938 |
Number Of Medicare Beneficiaries With Medical Services |
372 |
Total Medical Submitted Charge Amount |
653355 |
Total Medical Medicare Allowed Amount |
117513.54 |
Total Medical Medicare Payment Amount |
88924.14 |
Total Medical Medicare Standardized Payment Amount |
89850.23 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
226 |
Number Of Non Hispanic White Beneficiaries |
287 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
325 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.0368 |