National Provider Identifier [NPI]: |
1548262710 |
Last Name Of The Provider |
MCGOWEN |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6301 HARRIS PKWY STE 300 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761324249 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1952 |
Number Of Medicare Beneficiaries |
455 |
Total Submitted Charge Amount |
960636 |
Total Medicare Allowed Amount |
312583.68 |
Total Medicare Payment Amount |
232349.88 |
Total Medicare Standardized Payment Amount |
243710.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
4551 |
Total Drug Medicare AllowedAmount |
1994.53 |
Total Drug Medicare PaymentAmount |
1495.36 |
Total Drug Medicare Standardized Payment Amount |
1495.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
1933 |
Number Of Medicare Beneficiaries With Medical Services |
455 |
Total Medical Submitted Charge Amount |
956085 |
Total Medical Medicare Allowed Amount |
310589.15 |
Total Medical Medicare Payment Amount |
230854.52 |
Total Medical Medicare Standardized Payment Amount |
242214.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
256 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
264 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
399 |
Number Of Black or African American Beneficiaries |
25 |
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 |
418 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1983 |