National Provider Identifier [NPI]: |
1992783708 |
Last Name Of The Provider |
VALLE |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 HIGHLAND CROSS |
Street Address 2 Of The Provider |
SUITE 275 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770731741 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
113 |
Number Of Services |
1147 |
Number Of Medicare Beneficiaries |
613 |
Total Submitted Charge Amount |
486904.35 |
Total Medicare Allowed Amount |
109700.17 |
Total Medicare Payment Amount |
81845.24 |
Total Medicare Standardized Payment Amount |
83992.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
2344.4 |
Total Drug Medicare AllowedAmount |
100.07 |
Total Drug Medicare PaymentAmount |
74.53 |
Total Drug Medicare Standardized Payment Amount |
74.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
1052 |
Number Of Medicare Beneficiaries With Medical Services |
613 |
Total Medical Submitted Charge Amount |
484559.95 |
Total Medical Medicare Allowed Amount |
109600.1 |
Total Medical Medicare Payment Amount |
81770.71 |
Total Medical Medicare Standardized Payment Amount |
83917.63 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
219 |
Number Of Beneficiaries Age 75 to 84 |
175 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
373 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
505 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
495 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0128 |