National Provider Identifier [NPI]: |
1376599209 |
Last Name Of The Provider |
ALEXANDER |
First Name Of The Provider |
VINU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 S MAIN ST |
Street Address 2 Of The Provider |
1500 MAIN ST |
City Of The Provider |
FT WORTH |
Zip Code Of The Provider |
761044917 |
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 |
20 |
Number Of Services |
359 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
138827.82 |
Total Medicare Allowed Amount |
25827.42 |
Total Medicare Payment Amount |
18292.96 |
Total Medicare Standardized Payment Amount |
18832.25 |
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 |
20 |
Number Of Medical Services |
359 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
138827.82 |
Total Medical Medicare Allowed Amount |
25827.42 |
Total Medical Medicare Payment Amount |
18292.96 |
Total Medical Medicare Standardized Payment Amount |
18832.25 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
97 |
Number Of Black or African American Beneficiaries |
147 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5734 |