National Provider Identifier [NPI]: |
1033193677 |
Last Name Of The Provider |
SAULOG |
First Name Of The Provider |
RUBY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1731 HAGY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMARILLO |
Zip Code Of The Provider |
791061710 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1820 |
Number Of Medicare Beneficiaries |
683 |
Total Submitted Charge Amount |
422265.1 |
Total Medicare Allowed Amount |
180749.69 |
Total Medicare Payment Amount |
130529.72 |
Total Medicare Standardized Payment Amount |
142180.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
1820 |
Number Of Medicare Beneficiaries With Medical Services |
683 |
Total Medical Submitted Charge Amount |
422265.1 |
Total Medical Medicare Allowed Amount |
180749.69 |
Total Medical Medicare Payment Amount |
130529.72 |
Total Medical Medicare Standardized Payment Amount |
142180.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
318 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
337 |
Number Of Non Hispanic White Beneficiaries |
592 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
70 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
578 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4249 |