National Provider Identifier [NPI]: |
1023062833 |
Last Name Of The Provider |
HAMILTON |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3500 GASTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
75246 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
1347 |
Number Of Medicare Beneficiaries |
912 |
Total Submitted Charge Amount |
336606 |
Total Medicare Allowed Amount |
79853.82 |
Total Medicare Payment Amount |
60459.98 |
Total Medicare Standardized Payment Amount |
60997.48 |
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 |
57 |
Number Of Medical Services |
1347 |
Number Of Medicare Beneficiaries With Medical Services |
912 |
Total Medical Submitted Charge Amount |
336606 |
Total Medical Medicare Allowed Amount |
79853.82 |
Total Medical Medicare Payment Amount |
60459.98 |
Total Medical Medicare Standardized Payment Amount |
60997.48 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
175 |
Number Of Beneficiaries Age 65 to 74 |
421 |
Number Of Beneficiaries Age 75 to 84 |
241 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
493 |
Number Of Male Beneficiaries |
419 |
Number Of Non Hispanic White Beneficiaries |
654 |
Number Of Black or African American Beneficiaries |
157 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
72 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
708 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
204 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
35 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.4543 |