National Provider Identifier [NPI]: |
1669498523 |
Last Name Of The Provider |
PRESLEY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6100 HARRIS PARKWAY |
Street Address 2 Of The Provider |
SUITE 320 |
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761324133 |
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 |
90 |
Number Of Services |
2109 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
344759.25 |
Total Medicare Allowed Amount |
131301.57 |
Total Medicare Payment Amount |
97521.95 |
Total Medicare Standardized Payment Amount |
98868.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
768 |
Number Of Medicare Beneficiaries With Drug Services |
102 |
Total Drug Submitted ChargeAmount |
22762.25 |
Total Drug Medicare AllowedAmount |
8681.1 |
Total Drug Medicare PaymentAmount |
6767.42 |
Total Drug Medicare Standardized Payment Amount |
6767.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
1341 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
321997 |
Total Medical Medicare Allowed Amount |
122620.47 |
Total Medical Medicare Payment Amount |
90754.53 |
Total Medical Medicare Standardized Payment Amount |
92101.09 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
304 |
Number Of Black or African American Beneficiaries |
20 |
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 |
309 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3364 |