National Provider Identifier [NPI]: |
1992811335 |
Last Name Of The Provider |
WALDO |
First Name Of The Provider |
RICK |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4708 ALLIANCE BLVD STE 300 |
Street Address 2 Of The Provider |
BAYLOR MEDICAL PLAZA 1 |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750935339 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
5824 |
Number Of Medicare Beneficiaries |
617 |
Total Submitted Charge Amount |
430800.8 |
Total Medicare Allowed Amount |
213943.29 |
Total Medicare Payment Amount |
149153.63 |
Total Medicare Standardized Payment Amount |
161513.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
2169 |
Number Of Medicare Beneficiaries With Drug Services |
135 |
Total Drug Submitted ChargeAmount |
41943.5 |
Total Drug Medicare AllowedAmount |
19682.28 |
Total Drug Medicare PaymentAmount |
16470.88 |
Total Drug Medicare Standardized Payment Amount |
16470.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
3655 |
Number Of Medicare Beneficiaries With Medical Services |
617 |
Total Medical Submitted Charge Amount |
388857.3 |
Total Medical Medicare Allowed Amount |
194261.01 |
Total Medical Medicare Payment Amount |
132682.75 |
Total Medical Medicare Standardized Payment Amount |
145042.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
375 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
307 |
Number Of Male Beneficiaries |
310 |
Number Of Non Hispanic White Beneficiaries |
578 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.7972 |