National Provider Identifier [NPI]: |
1518151877 |
Last Name Of The Provider |
SANTIAGO |
First Name Of The Provider |
JUAN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1309 E RIDGE RD |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
MCALLEN |
Zip Code Of The Provider |
785031517 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
8397 |
Number Of Medicare Beneficiaries |
973 |
Total Submitted Charge Amount |
3978145 |
Total Medicare Allowed Amount |
2512537.51 |
Total Medicare Payment Amount |
1928716.48 |
Total Medicare Standardized Payment Amount |
1952593.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
3927 |
Number Of Medicare Beneficiaries With Drug Services |
275 |
Total Drug Submitted ChargeAmount |
2777005 |
Total Drug Medicare AllowedAmount |
2007820.26 |
Total Drug Medicare PaymentAmount |
1550179.8 |
Total Drug Medicare Standardized Payment Amount |
1550179.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
4470 |
Number Of Medicare Beneficiaries With Medical Services |
973 |
Total Medical Submitted Charge Amount |
1201140 |
Total Medical Medicare Allowed Amount |
504717.25 |
Total Medical Medicare Payment Amount |
378536.68 |
Total Medical Medicare Standardized Payment Amount |
402413.63 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
174 |
Number Of Beneficiaries Age 65 to 74 |
368 |
Number Of Beneficiaries Age 75 to 84 |
286 |
Number Of Beneficiaries Age Greater 84 |
145 |
Number Of Female Beneficiaries |
595 |
Number Of Male Beneficiaries |
378 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
697 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
433 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
540 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.4384 |