National Provider Identifier [NPI]: |
1417954124 |
Last Name Of The Provider |
HARRISON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 S BROADWAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MCALLEN |
Zip Code Of The Provider |
785014906 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
5997 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
5194105.25 |
Total Medicare Allowed Amount |
1458602.79 |
Total Medicare Payment Amount |
1138929.12 |
Total Medicare Standardized Payment Amount |
1216785.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
117 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
2359.6 |
Total Drug Medicare AllowedAmount |
939.43 |
Total Drug Medicare PaymentAmount |
736.95 |
Total Drug Medicare Standardized Payment Amount |
736.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
5880 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
5191745.65 |
Total Medical Medicare Allowed Amount |
1457663.36 |
Total Medical Medicare Payment Amount |
1138192.17 |
Total Medical Medicare Standardized Payment Amount |
1216048.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
151 |
Number Of Black or African American Beneficiaries |
|
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
56 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.055 |