National Provider Identifier [NPI]: |
1053311720 |
Last Name Of The Provider |
BRATOVICH |
First Name Of The Provider |
BORIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PAC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6560 FANNIN ST |
Street Address 2 Of The Provider |
SUITE 1842 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770302761 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
404 |
Number Of Medicare Beneficiaries |
199 |
Total Submitted Charge Amount |
982401 |
Total Medicare Allowed Amount |
80320.47 |
Total Medicare Payment Amount |
62254.04 |
Total Medicare Standardized Payment Amount |
63100.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
404 |
Number Of Medicare Beneficiaries With Medical Services |
199 |
Total Medical Submitted Charge Amount |
982401 |
Total Medical Medicare Allowed Amount |
80320.47 |
Total Medical Medicare Payment Amount |
62254.04 |
Total Medical Medicare Standardized Payment Amount |
63100.43 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
168 |
Number Of Black or African American Beneficiaries |
15 |
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 |
180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
55 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
68 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.5184 |