National Provider Identifier [NPI]: |
1609816933 |
Last Name Of The Provider |
DANIELS |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E DAWSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757012036 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
731 |
Number Of Medicare Beneficiaries |
616 |
Total Submitted Charge Amount |
782239.5 |
Total Medicare Allowed Amount |
89676.46 |
Total Medicare Payment Amount |
69786.59 |
Total Medicare Standardized Payment Amount |
72577.81 |
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 |
82 |
Number Of Medical Services |
731 |
Number Of Medicare Beneficiaries With Medical Services |
616 |
Total Medical Submitted Charge Amount |
782239.5 |
Total Medical Medicare Allowed Amount |
89676.46 |
Total Medical Medicare Payment Amount |
69786.59 |
Total Medical Medicare Standardized Payment Amount |
72577.81 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
275 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
312 |
Number Of Non Hispanic White Beneficiaries |
531 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
499 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.882 |