National Provider Identifier [NPI]: |
1336193903 |
Last Name Of The Provider |
TOOTHAKER-ALVAREZ |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17448 HIGHWAY 3 |
Street Address 2 Of The Provider |
SUITE 136 |
City Of The Provider |
WEBSTER |
Zip Code Of The Provider |
775984197 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
3159 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
418028.25 |
Total Medicare Allowed Amount |
219258.2 |
Total Medicare Payment Amount |
163040.49 |
Total Medicare Standardized Payment Amount |
160601.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
549 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
8061 |
Total Drug Medicare AllowedAmount |
4369.2 |
Total Drug Medicare PaymentAmount |
3344.39 |
Total Drug Medicare Standardized Payment Amount |
3344.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
2610 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
409967.25 |
Total Medical Medicare Allowed Amount |
214889 |
Total Medical Medicare Payment Amount |
159696.1 |
Total Medical Medicare Standardized Payment Amount |
157257.47 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
253 |
Number Of Black or African American Beneficiaries |
20 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4698 |