National Provider Identifier [NPI]: |
1538140223 |
Last Name Of The Provider |
OBERG |
First Name Of The Provider |
ERIK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3851 ROGER BROOKE DR # 3600 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782344501 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
289684 |
Total Medicare Allowed Amount |
29531.61 |
Total Medicare Payment Amount |
21953.12 |
Total Medicare Standardized Payment Amount |
22574.26 |
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 |
19 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
289684 |
Total Medical Medicare Allowed Amount |
29531.61 |
Total Medical Medicare Payment Amount |
21953.12 |
Total Medical Medicare Standardized Payment Amount |
22574.26 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
87 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9537 |