National Provider Identifier [NPI]: |
1013962349 |
Last Name Of The Provider |
FOSTER |
First Name Of The Provider |
TRAVIS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4375 BOOTH CALLOWAY RD |
Street Address 2 Of The Provider |
SUITE 501 |
City Of The Provider |
NORTH RICHLAND HILLS |
Zip Code Of The Provider |
761808359 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
106 |
Number Of Services |
811 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
636140.2 |
Total Medicare Allowed Amount |
229389.04 |
Total Medicare Payment Amount |
174959.12 |
Total Medicare Standardized Payment Amount |
181235.92 |
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 |
106 |
Number Of Medical Services |
811 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
636140.2 |
Total Medical Medicare Allowed Amount |
229389.04 |
Total Medical Medicare Payment Amount |
174959.12 |
Total Medical Medicare Standardized Payment Amount |
181235.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
213 |
Number Of Black or African American Beneficiaries |
28 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.8416 |