National Provider Identifier [NPI]: |
1215016480 |
Last Name Of The Provider |
VILLASENOR |
First Name Of The Provider |
HECTOR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
215 E QUINCY ST STE 427 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782152033 |
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 |
64 |
Number Of Services |
5335 |
Number Of Medicare Beneficiaries |
1023 |
Total Submitted Charge Amount |
1367813.4 |
Total Medicare Allowed Amount |
438510.01 |
Total Medicare Payment Amount |
322083.83 |
Total Medicare Standardized Payment Amount |
345683.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
721 |
Number Of Medicare Beneficiaries With Drug Services |
175 |
Total Drug Submitted ChargeAmount |
85289 |
Total Drug Medicare AllowedAmount |
33957.06 |
Total Drug Medicare PaymentAmount |
26181.06 |
Total Drug Medicare Standardized Payment Amount |
26181.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
62 |
Number Of Medical Services |
4614 |
Number Of Medicare Beneficiaries With Medical Services |
1023 |
Total Medical Submitted Charge Amount |
1282524.4 |
Total Medical Medicare Allowed Amount |
404552.95 |
Total Medical Medicare Payment Amount |
295902.77 |
Total Medical Medicare Standardized Payment Amount |
319502.77 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
354 |
Number Of Beneficiaries Age 75 to 84 |
348 |
Number Of Beneficiaries Age Greater 84 |
220 |
Number Of Female Beneficiaries |
566 |
Number Of Male Beneficiaries |
457 |
Number Of Non Hispanic White Beneficiaries |
157 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
831 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
504 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
519 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.056 |