National Provider Identifier [NPI]: |
1255588018 |
Last Name Of The Provider |
ADKISON |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 S 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPLE |
Zip Code Of The Provider |
765080001 |
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 |
130 |
Number Of Services |
6307 |
Number Of Medicare Beneficiaries |
3142 |
Total Submitted Charge Amount |
767475 |
Total Medicare Allowed Amount |
164706.96 |
Total Medicare Payment Amount |
121315.55 |
Total Medicare Standardized Payment Amount |
127706.04 |
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 |
130 |
Number Of Medical Services |
6307 |
Number Of Medicare Beneficiaries With Medical Services |
3142 |
Total Medical Submitted Charge Amount |
767475 |
Total Medical Medicare Allowed Amount |
164706.96 |
Total Medical Medicare Payment Amount |
121315.55 |
Total Medical Medicare Standardized Payment Amount |
127706.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
770 |
Number Of Beneficiaries Age 65 to 74 |
1073 |
Number Of Beneficiaries Age 75 to 84 |
813 |
Number Of Beneficiaries Age Greater 84 |
486 |
Number Of Female Beneficiaries |
1755 |
Number Of Male Beneficiaries |
1387 |
Number Of Non Hispanic White Beneficiaries |
2324 |
Number Of Black or African American Beneficiaries |
436 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
329 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
971 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0903 |