National Provider Identifier [NPI]: |
1255325114 |
Last Name Of The Provider |
TUMA |
First Name Of The Provider |
SAMIR |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1213 HERMANN DR |
Street Address 2 Of The Provider |
SUITE 700 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770047018 |
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 |
11 |
Number Of Services |
678 |
Number Of Medicare Beneficiaries |
85 |
Total Submitted Charge Amount |
371767.48 |
Total Medicare Allowed Amount |
158724.88 |
Total Medicare Payment Amount |
120196.61 |
Total Medicare Standardized Payment Amount |
119052.07 |
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 |
11 |
Number Of Medical Services |
678 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
371767.48 |
Total Medical Medicare Allowed Amount |
158724.88 |
Total Medical Medicare Payment Amount |
120196.61 |
Total Medical Medicare Standardized Payment Amount |
119052.07 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
23 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
50 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
6.6748 |