National Provider Identifier [NPI]: |
1063628964 |
Last Name Of The Provider |
MANUEL |
First Name Of The Provider |
JACOB |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 W 38TH ST |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787051127 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
2411 |
Number Of Medicare Beneficiaries |
387 |
Total Submitted Charge Amount |
1017172 |
Total Medicare Allowed Amount |
322007.97 |
Total Medicare Payment Amount |
241183.71 |
Total Medicare Standardized Payment Amount |
250854.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
386 |
Number Of Medicare Beneficiaries With Drug Services |
113 |
Total Drug Submitted ChargeAmount |
68656 |
Total Drug Medicare AllowedAmount |
40425.97 |
Total Drug Medicare PaymentAmount |
30680.42 |
Total Drug Medicare Standardized Payment Amount |
30680.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
2025 |
Number Of Medicare Beneficiaries With Medical Services |
387 |
Total Medical Submitted Charge Amount |
948516 |
Total Medical Medicare Allowed Amount |
281582 |
Total Medical Medicare Payment Amount |
210503.29 |
Total Medical Medicare Standardized Payment Amount |
220174.55 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
204 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
337 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9859 |