National Provider Identifier [NPI]: |
1699744144 |
Last Name Of The Provider |
MILCHGRUB |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907208 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
564 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
89916 |
Total Medicare Allowed Amount |
17696.7 |
Total Medicare Payment Amount |
13409.97 |
Total Medicare Standardized Payment Amount |
11268.84 |
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 |
16 |
Number Of Medical Services |
564 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
89916 |
Total Medical Medicare Allowed Amount |
17696.7 |
Total Medical Medicare Payment Amount |
13409.97 |
Total Medical Medicare Standardized Payment Amount |
11268.84 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
149 |
Number Of Black or African American Beneficiaries |
59 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.327 |