National Provider Identifier [NPI]: |
1326003625 |
Last Name Of The Provider |
WINSTON |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2100 REGIONAL MEDICAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHARTON |
Zip Code Of The Provider |
774889719 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
173 |
Number Of Services |
10201 |
Number Of Medicare Beneficiaries |
740 |
Total Submitted Charge Amount |
491308.73 |
Total Medicare Allowed Amount |
245525.78 |
Total Medicare Payment Amount |
183393.82 |
Total Medicare Standardized Payment Amount |
193881.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
2282 |
Number Of Medicare Beneficiaries With Drug Services |
265 |
Total Drug Submitted ChargeAmount |
57688.63 |
Total Drug Medicare AllowedAmount |
30721.48 |
Total Drug Medicare PaymentAmount |
26341.68 |
Total Drug Medicare Standardized Payment Amount |
26341.68 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
158 |
Number Of Medical Services |
7919 |
Number Of Medicare Beneficiaries With Medical Services |
740 |
Total Medical Submitted Charge Amount |
433620.1 |
Total Medical Medicare Allowed Amount |
214804.3 |
Total Medical Medicare Payment Amount |
157052.14 |
Total Medical Medicare Standardized Payment Amount |
167540.05 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
134 |
Number Of Beneficiaries Age 65 to 74 |
327 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
429 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
376 |
Number Of Black or African American Beneficiaries |
185 |
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 |
527 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
213 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1951 |