National Provider Identifier [NPI]: |
1508852021 |
Last Name Of The Provider |
HOLLANDER |
First Name Of The Provider |
IRA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 RIVER RUN |
Street Address 2 Of The Provider |
SUITE 902 |
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761076579 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
9617 |
Number Of Medicare Beneficiaries |
752 |
Total Submitted Charge Amount |
405807 |
Total Medicare Allowed Amount |
162560.13 |
Total Medicare Payment Amount |
115417.88 |
Total Medicare Standardized Payment Amount |
118036.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
7310 |
Number Of Medicare Beneficiaries With Drug Services |
107 |
Total Drug Submitted ChargeAmount |
98789 |
Total Drug Medicare AllowedAmount |
20851.47 |
Total Drug Medicare PaymentAmount |
14537.53 |
Total Drug Medicare Standardized Payment Amount |
14537.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
2307 |
Number Of Medicare Beneficiaries With Medical Services |
751 |
Total Medical Submitted Charge Amount |
307018 |
Total Medical Medicare Allowed Amount |
141708.66 |
Total Medical Medicare Payment Amount |
100880.35 |
Total Medical Medicare Standardized Payment Amount |
103498.49 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
320 |
Number Of Beneficiaries Age 75 to 84 |
245 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
559 |
Number Of Non Hispanic White Beneficiaries |
641 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
687 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4332 |