National Provider Identifier [NPI]: |
1710976907 |
Last Name Of The Provider |
WINTER |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2929 MOSSROCK |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782305110 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
939 |
Number Of Medicare Beneficiaries |
286 |
Total Submitted Charge Amount |
174970 |
Total Medicare Allowed Amount |
109163.18 |
Total Medicare Payment Amount |
77377.9 |
Total Medicare Standardized Payment Amount |
83066.42 |
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 |
26 |
Number Of Medical Services |
939 |
Number Of Medicare Beneficiaries With Medical Services |
286 |
Total Medical Submitted Charge Amount |
174970 |
Total Medical Medicare Allowed Amount |
109163.18 |
Total Medical Medicare Payment Amount |
77377.9 |
Total Medical Medicare Standardized Payment Amount |
83066.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
167 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
99 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
249 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2362 |