National Provider Identifier [NPI]: |
1720056773 |
Last Name Of The Provider |
RENNO |
First Name Of The Provider |
REEM |
Middle Initial Of The Provider |
Z |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13300 HARGRAVE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770704373 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
12741 |
Number Of Medicare Beneficiaries |
460 |
Total Submitted Charge Amount |
5999620 |
Total Medicare Allowed Amount |
4046467.25 |
Total Medicare Payment Amount |
3148609.25 |
Total Medicare Standardized Payment Amount |
3143107.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
8418 |
Number Of Medicare Beneficiaries With Drug Services |
165 |
Total Drug Submitted ChargeAmount |
4998000 |
Total Drug Medicare AllowedAmount |
3635978.99 |
Total Drug Medicare PaymentAmount |
2839673.11 |
Total Drug Medicare Standardized Payment Amount |
2839673.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
4323 |
Number Of Medicare Beneficiaries With Medical Services |
460 |
Total Medical Submitted Charge Amount |
1001620 |
Total Medical Medicare Allowed Amount |
410488.26 |
Total Medical Medicare Payment Amount |
308936.14 |
Total Medical Medicare Standardized Payment Amount |
303433.92 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
313 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
83 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
332 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.635 |