National Provider Identifier [NPI]: |
1477623551 |
Last Name Of The Provider |
CHRISTOPHER |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7501 LAKEVIEW PKWY STE 245 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROWLETT |
Zip Code Of The Provider |
750889326 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
498 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
79266 |
Total Medicare Allowed Amount |
34003.78 |
Total Medicare Payment Amount |
26824.58 |
Total Medicare Standardized Payment Amount |
26799.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
51 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
3485 |
Total Drug Medicare AllowedAmount |
1472.83 |
Total Drug Medicare PaymentAmount |
1443.26 |
Total Drug Medicare Standardized Payment Amount |
1443.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
447 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
75781 |
Total Medical Medicare Allowed Amount |
32530.95 |
Total Medical Medicare Payment Amount |
25381.32 |
Total Medical Medicare Standardized Payment Amount |
25356.42 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8541 |