National Provider Identifier [NPI]: |
1386895282 |
Last Name Of The Provider |
TRAN |
First Name Of The Provider |
LIEN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6301 HARRIS PKWY STE 300 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761324245 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1702 |
Number Of Medicare Beneficiaries |
357 |
Total Submitted Charge Amount |
230610 |
Total Medicare Allowed Amount |
67417.54 |
Total Medicare Payment Amount |
50401.84 |
Total Medicare Standardized Payment Amount |
56255.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
335 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
21674 |
Total Drug Medicare AllowedAmount |
10587.97 |
Total Drug Medicare PaymentAmount |
8245.53 |
Total Drug Medicare Standardized Payment Amount |
8245.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1367 |
Number Of Medicare Beneficiaries With Medical Services |
357 |
Total Medical Submitted Charge Amount |
208936 |
Total Medical Medicare Allowed Amount |
56829.57 |
Total Medical Medicare Payment Amount |
42156.31 |
Total Medical Medicare Standardized Payment Amount |
48009.87 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
314 |
Number Of Black or African American Beneficiaries |
23 |
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 |
338 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9932 |