National Provider Identifier [NPI]: |
1093093874 |
Last Name Of The Provider |
DEBELA |
First Name Of The Provider |
ZENEBE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7000 NORTH MOPAC |
Street Address 2 Of The Provider |
SUITE #420 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
78731 |
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 |
12 |
Number Of Services |
1887 |
Number Of Medicare Beneficiaries |
457 |
Total Submitted Charge Amount |
364900 |
Total Medicare Allowed Amount |
187565.86 |
Total Medicare Payment Amount |
142102.43 |
Total Medicare Standardized Payment Amount |
143623.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
1887 |
Number Of Medicare Beneficiaries With Medical Services |
457 |
Total Medical Submitted Charge Amount |
364900 |
Total Medical Medicare Allowed Amount |
187565.86 |
Total Medical Medicare Payment Amount |
142102.43 |
Total Medical Medicare Standardized Payment Amount |
143623.89 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
243 |
Number Of Black or African American Beneficiaries |
125 |
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 |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
179 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
2.803 |