National Provider Identifier [NPI]: |
1528051034 |
Last Name Of The Provider |
OZANNE |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
128 W BELT LINE RD |
Street Address 2 Of The Provider |
SUITE #1 |
City Of The Provider |
CEDAR HILL |
Zip Code Of The Provider |
751042094 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
439 |
Number Of Medicare Beneficiaries |
202 |
Total Submitted Charge Amount |
156536.71 |
Total Medicare Allowed Amount |
78876.25 |
Total Medicare Payment Amount |
57824.1 |
Total Medicare Standardized Payment Amount |
60359.57 |
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 |
33 |
Number Of Medical Services |
439 |
Number Of Medicare Beneficiaries With Medical Services |
202 |
Total Medical Submitted Charge Amount |
156536.71 |
Total Medical Medicare Allowed Amount |
78876.25 |
Total Medical Medicare Payment Amount |
57824.1 |
Total Medical Medicare Standardized Payment Amount |
60359.57 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
133 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
11 |
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1579 |