National Provider Identifier [NPI]: |
1396710984 |
Last Name Of The Provider |
OSTRANSKY |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2801 S HULEN ST |
Street Address 2 Of The Provider |
SUITE 600 |
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761091517 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2450 |
Number Of Medicare Beneficiaries |
830 |
Total Submitted Charge Amount |
761237.37 |
Total Medicare Allowed Amount |
296550.01 |
Total Medicare Payment Amount |
217702.81 |
Total Medicare Standardized Payment Amount |
226386.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
73 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
837.68 |
Total Drug Medicare AllowedAmount |
340.42 |
Total Drug Medicare PaymentAmount |
299.82 |
Total Drug Medicare Standardized Payment Amount |
299.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
2377 |
Number Of Medicare Beneficiaries With Medical Services |
830 |
Total Medical Submitted Charge Amount |
760399.69 |
Total Medical Medicare Allowed Amount |
296209.59 |
Total Medical Medicare Payment Amount |
217402.99 |
Total Medical Medicare Standardized Payment Amount |
226086.37 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
454 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
413 |
Number Of Male Beneficiaries |
417 |
Number Of Non Hispanic White Beneficiaries |
718 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
728 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3708 |