National Provider Identifier [NPI]: |
1043207962 |
Last Name Of The Provider |
MELVIN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N HIGH ST |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
756525983 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
146 |
Number Of Services |
4394 |
Number Of Medicare Beneficiaries |
1545 |
Total Submitted Charge Amount |
684274 |
Total Medicare Allowed Amount |
117740.73 |
Total Medicare Payment Amount |
85564.32 |
Total Medicare Standardized Payment Amount |
90212.62 |
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 |
146 |
Number Of Medical Services |
4394 |
Number Of Medicare Beneficiaries With Medical Services |
1545 |
Total Medical Submitted Charge Amount |
684274 |
Total Medical Medicare Allowed Amount |
117740.73 |
Total Medical Medicare Payment Amount |
85564.32 |
Total Medical Medicare Standardized Payment Amount |
90212.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
287 |
Number Of Beneficiaries Age 65 to 74 |
586 |
Number Of Beneficiaries Age 75 to 84 |
398 |
Number Of Beneficiaries Age Greater 84 |
274 |
Number Of Female Beneficiaries |
999 |
Number Of Male Beneficiaries |
546 |
Number Of Non Hispanic White Beneficiaries |
1197 |
Number Of Black or African American Beneficiaries |
289 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1055 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
490 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3987 |