National Provider Identifier [NPI]: |
1770786915 |
Last Name Of The Provider |
GRAHAM |
First Name Of The Provider |
BELINDA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6101 WINDCOM CT |
Street Address 2 Of The Provider |
#400 |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750937817 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
6382 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
146599.6 |
Total Medicare Allowed Amount |
78598.71 |
Total Medicare Payment Amount |
59438.75 |
Total Medicare Standardized Payment Amount |
61281.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
766.6 |
Total Drug Medicare AllowedAmount |
477.63 |
Total Drug Medicare PaymentAmount |
466.34 |
Total Drug Medicare Standardized Payment Amount |
466.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
6354 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
145833 |
Total Medical Medicare Allowed Amount |
78121.08 |
Total Medical Medicare Payment Amount |
58972.41 |
Total Medical Medicare Standardized Payment Amount |
60815.64 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
109 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
33 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9833 |