National Provider Identifier [NPI]: |
1932213402 |
Last Name Of The Provider |
HAAG |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 W ARBROOK BLVD STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760143175 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
2168 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
180502.5 |
Total Medicare Allowed Amount |
75112.29 |
Total Medicare Payment Amount |
52641.88 |
Total Medicare Standardized Payment Amount |
62023.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
167 |
Number Of Medicare Beneficiaries With Drug Services |
69 |
Total Drug Submitted ChargeAmount |
5253.5 |
Total Drug Medicare AllowedAmount |
1278.54 |
Total Drug Medicare PaymentAmount |
1236.31 |
Total Drug Medicare Standardized Payment Amount |
1236.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
2001 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
175249 |
Total Medical Medicare Allowed Amount |
73833.75 |
Total Medical Medicare Payment Amount |
51405.57 |
Total Medical Medicare Standardized Payment Amount |
60787.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
29 |
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 |
303 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1099 |