National Provider Identifier [NPI]: |
1073708996 |
Last Name Of The Provider |
CRUZ |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
720 PLEASANTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782141306 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
568 |
Number Of Medicare Beneficiaries |
197 |
Total Submitted Charge Amount |
99460.69 |
Total Medicare Allowed Amount |
40636.13 |
Total Medicare Payment Amount |
29467.49 |
Total Medicare Standardized Payment Amount |
31087.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
139.09 |
Total Drug Medicare AllowedAmount |
55.38 |
Total Drug Medicare PaymentAmount |
37.89 |
Total Drug Medicare Standardized Payment Amount |
37.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
510 |
Number Of Medicare Beneficiaries With Medical Services |
197 |
Total Medical Submitted Charge Amount |
99321.6 |
Total Medical Medicare Allowed Amount |
40580.75 |
Total Medical Medicare Payment Amount |
29429.6 |
Total Medical Medicare Standardized Payment Amount |
31049.39 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
150 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.9424 |