National Provider Identifier [NPI]: |
1922042639 |
Last Name Of The Provider |
SHAY |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2710 HOSPITAL DRIVE, SUITE 102 |
Street Address 2 Of The Provider |
|
City Of The Provider |
VICTORIA |
Zip Code Of The Provider |
77901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
9895 |
Number Of Medicare Beneficiaries |
645 |
Total Submitted Charge Amount |
506632 |
Total Medicare Allowed Amount |
368832.66 |
Total Medicare Payment Amount |
269255.58 |
Total Medicare Standardized Payment Amount |
280730.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
3293 |
Number Of Medicare Beneficiaries With Drug Services |
302 |
Total Drug Submitted ChargeAmount |
67325 |
Total Drug Medicare AllowedAmount |
47132.06 |
Total Drug Medicare PaymentAmount |
37022.27 |
Total Drug Medicare Standardized Payment Amount |
37022.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
62 |
Number Of Medical Services |
6602 |
Number Of Medicare Beneficiaries With Medical Services |
645 |
Total Medical Submitted Charge Amount |
439307 |
Total Medical Medicare Allowed Amount |
321700.6 |
Total Medical Medicare Payment Amount |
232233.31 |
Total Medical Medicare Standardized Payment Amount |
243708.55 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
252 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
370 |
Number Of Male Beneficiaries |
275 |
Number Of Non Hispanic White Beneficiaries |
529 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
596 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2331 |