National Provider Identifier [NPI]: |
1093701468 |
Last Name Of The Provider |
PAULGER |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2202 ITHACA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUBBOCK |
Zip Code Of The Provider |
794101332 |
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 |
104 |
Number Of Services |
14632 |
Number Of Medicare Beneficiaries |
1936 |
Total Submitted Charge Amount |
1372840.18 |
Total Medicare Allowed Amount |
1141789.54 |
Total Medicare Payment Amount |
837331.24 |
Total Medicare Standardized Payment Amount |
846253.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
222 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
3374 |
Total Drug Medicare AllowedAmount |
677.19 |
Total Drug Medicare PaymentAmount |
413.96 |
Total Drug Medicare Standardized Payment Amount |
413.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
100 |
Number Of Medical Services |
14410 |
Number Of Medicare Beneficiaries With Medical Services |
1936 |
Total Medical Submitted Charge Amount |
1369466.18 |
Total Medical Medicare Allowed Amount |
1141112.35 |
Total Medical Medicare Payment Amount |
836917.28 |
Total Medical Medicare Standardized Payment Amount |
845839.29 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
809 |
Number Of Beneficiaries Age 75 to 84 |
778 |
Number Of Beneficiaries Age Greater 84 |
301 |
Number Of Female Beneficiaries |
976 |
Number Of Male Beneficiaries |
960 |
Number Of Non Hispanic White Beneficiaries |
1884 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1885 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9756 |