National Provider Identifier [NPI]: |
1669563656 |
Last Name Of The Provider |
WHITNEY |
First Name Of The Provider |
EDWIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1933 NE LOOP 410 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
78217 |
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 |
63 |
Number Of Services |
4957 |
Number Of Medicare Beneficiaries |
1373 |
Total Submitted Charge Amount |
1634129.98 |
Total Medicare Allowed Amount |
528791.02 |
Total Medicare Payment Amount |
382468.42 |
Total Medicare Standardized Payment Amount |
411989.21 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
549 |
Number Of Beneficiaries Age 75 to 84 |
521 |
Number Of Beneficiaries Age Greater 84 |
207 |
Number Of Female Beneficiaries |
633 |
Number Of Male Beneficiaries |
740 |
Number Of Non Hispanic White Beneficiaries |
1082 |
Number Of Black or African American Beneficiaries |
84 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
180 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1288 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3629 |