National Provider Identifier [NPI]: |
1245234293 |
Last Name Of The Provider |
AGOSTINI |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6200 I-40 W |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMARILLO |
Zip Code Of The Provider |
791062512 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
119 |
Number Of Services |
6215 |
Number Of Medicare Beneficiaries |
1403 |
Total Submitted Charge Amount |
3193128.52 |
Total Medicare Allowed Amount |
1116347.13 |
Total Medicare Payment Amount |
858230.14 |
Total Medicare Standardized Payment Amount |
915935.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
731 |
Number Of Medicare Beneficiaries With Drug Services |
183 |
Total Drug Submitted ChargeAmount |
31069 |
Total Drug Medicare AllowedAmount |
24225.27 |
Total Drug Medicare PaymentAmount |
18867.86 |
Total Drug Medicare Standardized Payment Amount |
18867.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
112 |
Number Of Medical Services |
5484 |
Number Of Medicare Beneficiaries With Medical Services |
1403 |
Total Medical Submitted Charge Amount |
3162059.52 |
Total Medical Medicare Allowed Amount |
1092121.86 |
Total Medical Medicare Payment Amount |
839362.28 |
Total Medical Medicare Standardized Payment Amount |
897067.24 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
581 |
Number Of Beneficiaries Age 75 to 84 |
525 |
Number Of Beneficiaries Age Greater 84 |
170 |
Number Of Female Beneficiaries |
750 |
Number Of Male Beneficiaries |
653 |
Number Of Non Hispanic White Beneficiaries |
1212 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
134 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
193 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3899 |