National Provider Identifier [NPI]: |
1205813359 |
Last Name Of The Provider |
ALBRITTON |
First Name Of The Provider |
TIFFANY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14823 SOUTHWEST FWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUGAR LAND |
Zip Code Of The Provider |
774785016 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
465 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
64655.33 |
Total Medicare Allowed Amount |
33489.72 |
Total Medicare Payment Amount |
21473.91 |
Total Medicare Standardized Payment Amount |
23529.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
44 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
2682.43 |
Total Drug Medicare AllowedAmount |
1591.23 |
Total Drug Medicare PaymentAmount |
1558.4 |
Total Drug Medicare Standardized Payment Amount |
1558.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
421 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
61972.9 |
Total Medical Medicare Allowed Amount |
31898.49 |
Total Medical Medicare Payment Amount |
19915.51 |
Total Medical Medicare Standardized Payment Amount |
21970.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
116 |
Number Of Black or African American Beneficiaries |
12 |
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 |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
14 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8875 |