National Provider Identifier [NPI]: |
1265669881 |
Last Name Of The Provider |
PURYEAR |
First Name Of The Provider |
ANGEL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5044 TENNYSON PKWY |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750242952 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
5836 |
Number Of Medicare Beneficiaries |
960 |
Total Submitted Charge Amount |
658817.33 |
Total Medicare Allowed Amount |
338161.47 |
Total Medicare Payment Amount |
247259.71 |
Total Medicare Standardized Payment Amount |
260055.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
98 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
20141 |
Total Drug Medicare AllowedAmount |
19500.25 |
Total Drug Medicare PaymentAmount |
14304.23 |
Total Drug Medicare Standardized Payment Amount |
14304.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
5738 |
Number Of Medicare Beneficiaries With Medical Services |
960 |
Total Medical Submitted Charge Amount |
638676.33 |
Total Medical Medicare Allowed Amount |
318661.22 |
Total Medical Medicare Payment Amount |
232955.48 |
Total Medical Medicare Standardized Payment Amount |
245750.81 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
548 |
Number Of Beneficiaries Age 75 to 84 |
258 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
507 |
Number Of Male Beneficiaries |
453 |
Number Of Non Hispanic White Beneficiaries |
887 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
938 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9363 |