National Provider Identifier [NPI]: |
1245387059 |
Last Name Of The Provider |
HORRALL |
First Name Of The Provider |
SHAWN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 S 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPLE |
Zip Code Of The Provider |
765080001 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
753 |
Number Of Medicare Beneficiaries |
650 |
Total Submitted Charge Amount |
307519 |
Total Medicare Allowed Amount |
90285.53 |
Total Medicare Payment Amount |
66497.81 |
Total Medicare Standardized Payment Amount |
68580.05 |
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 |
35 |
Number Of Medical Services |
753 |
Number Of Medicare Beneficiaries With Medical Services |
650 |
Total Medical Submitted Charge Amount |
307519 |
Total Medical Medicare Allowed Amount |
90285.53 |
Total Medical Medicare Payment Amount |
66497.81 |
Total Medical Medicare Standardized Payment Amount |
68580.05 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
226 |
Number Of Beneficiaries Age 65 to 74 |
210 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
268 |
Number Of Non Hispanic White Beneficiaries |
452 |
Number Of Black or African American Beneficiaries |
107 |
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 |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2413 |