National Provider Identifier [NPI]: |
1861412744 |
Last Name Of The Provider |
SILVERMAN |
First Name Of The Provider |
JERRY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1315 ST JOSEPH PKWY STE 1002 |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770028231 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
221 |
Number Of Medicare Beneficiaries |
53 |
Total Submitted Charge Amount |
21830 |
Total Medicare Allowed Amount |
13051.35 |
Total Medicare Payment Amount |
8881.04 |
Total Medicare Standardized Payment Amount |
8825.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
180 |
Total Drug Medicare AllowedAmount |
61.01 |
Total Drug Medicare PaymentAmount |
42.75 |
Total Drug Medicare Standardized Payment Amount |
42.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
203 |
Number Of Medicare Beneficiaries With Medical Services |
53 |
Total Medical Submitted Charge Amount |
21650 |
Total Medical Medicare Allowed Amount |
12990.34 |
Total Medical Medicare Payment Amount |
8838.29 |
Total Medical Medicare Standardized Payment Amount |
8782.95 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
15 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
16 |
Number Of Non Hispanic White Beneficiaries |
14 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6362 |