National Provider Identifier [NPI]: |
1912939281 |
Last Name Of The Provider |
HOUSTON |
First Name Of The Provider |
BRIAN |
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 |
1199 VAN VOORHIS RD |
Street Address 2 Of The Provider |
STE 5 |
City Of The Provider |
MORGANTOWN |
Zip Code Of The Provider |
26505 |
State Code Of The Provider |
WV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
924 |
Number Of Medicare Beneficiaries |
382 |
Total Submitted Charge Amount |
73029.35 |
Total Medicare Allowed Amount |
72945.42 |
Total Medicare Payment Amount |
48778.7 |
Total Medicare Standardized Payment Amount |
55818.58 |
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 |
7 |
Number Of Medical Services |
924 |
Number Of Medicare Beneficiaries With Medical Services |
382 |
Total Medical Submitted Charge Amount |
73029.35 |
Total Medical Medicare Allowed Amount |
72945.42 |
Total Medical Medicare Payment Amount |
48778.7 |
Total Medical Medicare Standardized Payment Amount |
55818.58 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
245 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
370 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
340 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.108 |