National Provider Identifier [NPI]: |
1861593170 |
Last Name Of The Provider |
WAGUESPACK |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 HOLCOMBE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770304009 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
305 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
70749 |
Total Medicare Allowed Amount |
23530.02 |
Total Medicare Payment Amount |
17243.01 |
Total Medicare Standardized Payment Amount |
17339.74 |
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 |
13 |
Number Of Medical Services |
305 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
70749 |
Total Medical Medicare Allowed Amount |
23530.02 |
Total Medical Medicare Payment Amount |
17243.01 |
Total Medical Medicare Standardized Payment Amount |
17339.74 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
121 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.1694 |