National Provider Identifier [NPI]: |
1295705325 |
Last Name Of The Provider |
AYO |
First Name Of The Provider |
DEREJE |
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 |
11797 SOUTH FWY |
Street Address 2 Of The Provider |
SUITE 330 |
City Of The Provider |
BURLESON |
Zip Code Of The Provider |
760287035 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
2818 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
686088 |
Total Medicare Allowed Amount |
291737 |
Total Medicare Payment Amount |
225958.6 |
Total Medicare Standardized Payment Amount |
229108.44 |
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 |
29 |
Number Of Medical Services |
2818 |
Number Of Medicare Beneficiaries With Medical Services |
437 |
Total Medical Submitted Charge Amount |
686088 |
Total Medical Medicare Allowed Amount |
291737 |
Total Medical Medicare Payment Amount |
225958.6 |
Total Medical Medicare Standardized Payment Amount |
229108.44 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
303 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
69 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.9384 |