National Provider Identifier [NPI]: |
1851351191 |
Last Name Of The Provider |
EDWARDS |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2600 LOCKWOOD |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
TAHOKA |
Zip Code Of The Provider |
79373 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1670 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
118712 |
Total Medicare Allowed Amount |
58412.6 |
Total Medicare Payment Amount |
39673.78 |
Total Medicare Standardized Payment Amount |
42662.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
868 |
Number Of Medicare Beneficiaries With Drug Services |
69 |
Total Drug Submitted ChargeAmount |
9304 |
Total Drug Medicare AllowedAmount |
1018.74 |
Total Drug Medicare PaymentAmount |
688.52 |
Total Drug Medicare Standardized Payment Amount |
688.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
802 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
109408 |
Total Medical Medicare Allowed Amount |
57393.86 |
Total Medical Medicare Payment Amount |
38985.26 |
Total Medical Medicare Standardized Payment Amount |
41974.13 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
209 |
Number Of Black or African American Beneficiaries |
|
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 |
204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0844 |