National Provider Identifier [NPI]: |
1194700542 |
Last Name Of The Provider |
MCKINNEY |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8210 WALNUT HILL LN |
Street Address 2 Of The Provider |
SUITE 230 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752314405 |
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 |
58 |
Number Of Services |
4774 |
Number Of Medicare Beneficiaries |
486 |
Total Submitted Charge Amount |
348842 |
Total Medicare Allowed Amount |
216091.53 |
Total Medicare Payment Amount |
167660.03 |
Total Medicare Standardized Payment Amount |
168160.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
219 |
Number Of Medicare Beneficiaries With Drug Services |
170 |
Total Drug Submitted ChargeAmount |
14330 |
Total Drug Medicare AllowedAmount |
7828.3 |
Total Drug Medicare PaymentAmount |
7570.75 |
Total Drug Medicare Standardized Payment Amount |
7570.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
4555 |
Number Of Medicare Beneficiaries With Medical Services |
486 |
Total Medical Submitted Charge Amount |
334512 |
Total Medical Medicare Allowed Amount |
208263.23 |
Total Medical Medicare Payment Amount |
160089.28 |
Total Medical Medicare Standardized Payment Amount |
160589.66 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
267 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
415 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
448 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9177 |