National Provider Identifier [NPI]: |
1316946064 |
Last Name Of The Provider |
HALEY |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1626 FOREST LN S |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
GARLAND |
Zip Code Of The Provider |
750427961 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
5355 |
Number Of Medicare Beneficiaries |
2065 |
Total Submitted Charge Amount |
1471216.5 |
Total Medicare Allowed Amount |
731600.09 |
Total Medicare Payment Amount |
511643.25 |
Total Medicare Standardized Payment Amount |
517872.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
213 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
60367.5 |
Total Drug Medicare AllowedAmount |
53406.56 |
Total Drug Medicare PaymentAmount |
38964.98 |
Total Drug Medicare Standardized Payment Amount |
38964.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
5142 |
Number Of Medicare Beneficiaries With Medical Services |
2065 |
Total Medical Submitted Charge Amount |
1410849 |
Total Medical Medicare Allowed Amount |
678193.53 |
Total Medical Medicare Payment Amount |
472678.27 |
Total Medical Medicare Standardized Payment Amount |
478907.18 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
851 |
Number Of Beneficiaries Age 75 to 84 |
826 |
Number Of Beneficiaries Age Greater 84 |
310 |
Number Of Female Beneficiaries |
1230 |
Number Of Male Beneficiaries |
835 |
Number Of Non Hispanic White Beneficiaries |
1761 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
81 |
Number Of Hispanic Beneficiaries |
99 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1895 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
170 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0491 |