National Provider Identifier [NPI]: |
1093819682 |
Last Name Of The Provider |
OHABOR |
First Name Of The Provider |
CONSTANTINE |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5501 S MCCOLL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINBURG |
Zip Code Of The Provider |
785399152 |
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 |
16 |
Number Of Services |
1359 |
Number Of Medicare Beneficiaries |
530 |
Total Submitted Charge Amount |
422107 |
Total Medicare Allowed Amount |
153306.87 |
Total Medicare Payment Amount |
117933.17 |
Total Medicare Standardized Payment Amount |
122985.27 |
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 |
16 |
Number Of Medical Services |
1359 |
Number Of Medicare Beneficiaries With Medical Services |
530 |
Total Medical Submitted Charge Amount |
422107 |
Total Medical Medicare Allowed Amount |
153306.87 |
Total Medical Medicare Payment Amount |
117933.17 |
Total Medical Medicare Standardized Payment Amount |
122985.27 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
402 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
331 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
72 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.9887 |