National Provider Identifier [NPI]: |
1649232562 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
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 |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
656 |
Number Of Medicare Beneficiaries |
482 |
Total Submitted Charge Amount |
469442 |
Total Medicare Allowed Amount |
96649.39 |
Total Medicare Payment Amount |
74771.56 |
Total Medicare Standardized Payment Amount |
78451.51 |
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 |
50 |
Number Of Medical Services |
656 |
Number Of Medicare Beneficiaries With Medical Services |
482 |
Total Medical Submitted Charge Amount |
469442 |
Total Medical Medicare Allowed Amount |
96649.39 |
Total Medical Medicare Payment Amount |
74771.56 |
Total Medical Medicare Standardized Payment Amount |
78451.51 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
269 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
358 |
Number Of Black or African American Beneficiaries |
63 |
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 |
368 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.51 |