National Provider Identifier [NPI]: |
1992766091 |
Last Name Of The Provider |
CALI |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 OLYMPIC PLAZA CIR |
Street Address 2 Of The Provider |
SUITE 418 |
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757011951 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
660 |
Number Of Medicare Beneficiaries |
248 |
Total Submitted Charge Amount |
250876 |
Total Medicare Allowed Amount |
97796.04 |
Total Medicare Payment Amount |
73280.31 |
Total Medicare Standardized Payment Amount |
78091.58 |
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 |
68 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
209 |
Number Of Black or African American Beneficiaries |
|
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 |
198 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1963 |