National Provider Identifier [NPI]: |
1194708974 |
Last Name Of The Provider |
SCHULTZ |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1201 DAIRY ASHFORD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770793017 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
3148 |
Number Of Medicare Beneficiaries |
911 |
Total Submitted Charge Amount |
214936.58 |
Total Medicare Allowed Amount |
148357.31 |
Total Medicare Payment Amount |
101536.2 |
Total Medicare Standardized Payment Amount |
102711.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
21 |
Number Of Drug Services |
1157 |
Number Of Medicare Beneficiaries With Drug Services |
350 |
Total Drug Submitted ChargeAmount |
21595.98 |
Total Drug Medicare AllowedAmount |
14481.54 |
Total Drug Medicare PaymentAmount |
12773.88 |
Total Drug Medicare Standardized Payment Amount |
12773.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
1991 |
Number Of Medicare Beneficiaries With Medical Services |
910 |
Total Medical Submitted Charge Amount |
193340.6 |
Total Medical Medicare Allowed Amount |
133875.77 |
Total Medical Medicare Payment Amount |
88762.32 |
Total Medical Medicare Standardized Payment Amount |
89938.01 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
367 |
Number Of Beneficiaries Age 75 to 84 |
317 |
Number Of Beneficiaries Age Greater 84 |
204 |
Number Of Female Beneficiaries |
491 |
Number Of Male Beneficiaries |
420 |
Number Of Non Hispanic White Beneficiaries |
840 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
898 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
0.9769 |