National Provider Identifier [NPI]: |
1861451502 |
Last Name Of The Provider |
MACURAK |
First Name Of The Provider |
RANDALL |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3430 W. WHEATLAND ROAD |
Street Address 2 Of The Provider |
CHARLTON I POB, SUITE 109 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
75237 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1945 |
Number Of Medicare Beneficiaries |
623 |
Total Submitted Charge Amount |
780625 |
Total Medicare Allowed Amount |
212683.81 |
Total Medicare Payment Amount |
161065.12 |
Total Medicare Standardized Payment Amount |
162861.94 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
271 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
357 |
Number Of Black or African American Beneficiaries |
223 |
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 |
484 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0448 |