National Provider Identifier [NPI]: |
1700829249 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
MONTE |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4510 MEDICAL CENTER DR |
Street Address 2 Of The Provider |
SUITE 215 |
City Of The Provider |
MCKINNEY |
Zip Code Of The Provider |
750691650 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
131 |
Number Of Services |
73498 |
Number Of Medicare Beneficiaries |
217 |
Total Submitted Charge Amount |
4299885 |
Total Medicare Allowed Amount |
1163992.77 |
Total Medicare Payment Amount |
911565.37 |
Total Medicare Standardized Payment Amount |
914561.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
63 |
Number Of Drug Services |
67196 |
Number Of Medicare Beneficiaries With Drug Services |
72 |
Total Drug Submitted ChargeAmount |
3505491 |
Total Drug Medicare AllowedAmount |
951776.25 |
Total Drug Medicare PaymentAmount |
741799.79 |
Total Drug Medicare Standardized Payment Amount |
741799.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
6302 |
Number Of Medicare Beneficiaries With Medical Services |
217 |
Total Medical Submitted Charge Amount |
794394 |
Total Medical Medicare Allowed Amount |
212216.52 |
Total Medical Medicare Payment Amount |
169765.58 |
Total Medical Medicare Standardized Payment Amount |
172761.67 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
196 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
54 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7792 |