National Provider Identifier [NPI]: |
1568447175 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9600 N. CENTRAL EXPRESSWAY |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752315078 |
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 |
63 |
Number Of Services |
11233 |
Number Of Medicare Beneficiaries |
1339 |
Total Submitted Charge Amount |
5629080.92 |
Total Medicare Allowed Amount |
2262328.74 |
Total Medicare Payment Amount |
1731172.28 |
Total Medicare Standardized Payment Amount |
1756891.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
3454 |
Number Of Medicare Beneficiaries With Drug Services |
384 |
Total Drug Submitted ChargeAmount |
2776706.92 |
Total Drug Medicare AllowedAmount |
1437759.04 |
Total Drug Medicare PaymentAmount |
1123513.5 |
Total Drug Medicare Standardized Payment Amount |
1123513.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
7779 |
Number Of Medicare Beneficiaries With Medical Services |
1339 |
Total Medical Submitted Charge Amount |
2852374 |
Total Medical Medicare Allowed Amount |
824569.7 |
Total Medical Medicare Payment Amount |
607658.78 |
Total Medical Medicare Standardized Payment Amount |
633377.78 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
528 |
Number Of Beneficiaries Age 75 to 84 |
436 |
Number Of Beneficiaries Age Greater 84 |
257 |
Number Of Female Beneficiaries |
775 |
Number Of Male Beneficiaries |
564 |
Number Of Non Hispanic White Beneficiaries |
1118 |
Number Of Black or African American Beneficiaries |
80 |
Number Of AsianPacific Islander Beneficiaries |
53 |
Number Of Hispanic Beneficiaries |
56 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
1177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3418 |