National Provider Identifier [NPI]: |
1568428589 |
Last Name Of The Provider |
HERNANDEZ |
First Name Of The Provider |
ARTHUR |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
88 BRIGGS ST |
Street Address 2 Of The Provider |
STE 250 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782241271 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
10552 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
792103.44 |
Total Medicare Allowed Amount |
393359.32 |
Total Medicare Payment Amount |
302013.54 |
Total Medicare Standardized Payment Amount |
345357.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
3057 |
Number Of Medicare Beneficiaries With Drug Services |
171 |
Total Drug Submitted ChargeAmount |
18429.9 |
Total Drug Medicare AllowedAmount |
9994.03 |
Total Drug Medicare PaymentAmount |
7758.08 |
Total Drug Medicare Standardized Payment Amount |
7758.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
7495 |
Number Of Medicare Beneficiaries With Medical Services |
398 |
Total Medical Submitted Charge Amount |
773673.54 |
Total Medical Medicare Allowed Amount |
383365.29 |
Total Medical Medicare Payment Amount |
294255.46 |
Total Medical Medicare Standardized Payment Amount |
337599.84 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
313 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
103 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
229 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
304 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8235 |