National Provider Identifier [NPI]: |
1609049956 |
Last Name Of The Provider |
MCGINNIS |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5002 COWHORN CREEK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEXARKANA |
Zip Code Of The Provider |
755039766 |
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 |
144 |
Number Of Services |
19526 |
Number Of Medicare Beneficiaries |
2891 |
Total Submitted Charge Amount |
922606.05 |
Total Medicare Allowed Amount |
244540.23 |
Total Medicare Payment Amount |
191052.11 |
Total Medicare Standardized Payment Amount |
207622.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
15409 |
Number Of Medicare Beneficiaries With Drug Services |
200 |
Total Drug Submitted ChargeAmount |
31574.3 |
Total Drug Medicare AllowedAmount |
5179.37 |
Total Drug Medicare PaymentAmount |
4035.89 |
Total Drug Medicare Standardized Payment Amount |
4035.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
140 |
Number Of Medical Services |
4117 |
Number Of Medicare Beneficiaries With Medical Services |
2891 |
Total Medical Submitted Charge Amount |
891031.75 |
Total Medical Medicare Allowed Amount |
239360.86 |
Total Medical Medicare Payment Amount |
187016.22 |
Total Medical Medicare Standardized Payment Amount |
203586.83 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
449 |
Number Of Beneficiaries Age 65 to 74 |
1273 |
Number Of Beneficiaries Age 75 to 84 |
897 |
Number Of Beneficiaries Age Greater 84 |
272 |
Number Of Female Beneficiaries |
1872 |
Number Of Male Beneficiaries |
1019 |
Number Of Non Hispanic White Beneficiaries |
2315 |
Number Of Black or African American Beneficiaries |
505 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
2476 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
415 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3054 |