National Provider Identifier [NPI]: |
1992708820 |
Last Name Of The Provider |
HARO |
First Name Of The Provider |
JULIAN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 W KOENIG LN |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787511213 |
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 |
72 |
Number Of Services |
20434 |
Number Of Medicare Beneficiaries |
644 |
Total Submitted Charge Amount |
1586301.55 |
Total Medicare Allowed Amount |
672927.58 |
Total Medicare Payment Amount |
544238.2 |
Total Medicare Standardized Payment Amount |
547540.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
4667 |
Number Of Medicare Beneficiaries With Drug Services |
75 |
Total Drug Submitted ChargeAmount |
47317.05 |
Total Drug Medicare AllowedAmount |
16574.74 |
Total Drug Medicare PaymentAmount |
8140.56 |
Total Drug Medicare Standardized Payment Amount |
8140.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
15767 |
Number Of Medicare Beneficiaries With Medical Services |
644 |
Total Medical Submitted Charge Amount |
1538984.5 |
Total Medical Medicare Allowed Amount |
656352.84 |
Total Medical Medicare Payment Amount |
536097.64 |
Total Medical Medicare Standardized Payment Amount |
539399.99 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
294 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
396 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
516 |
Number Of Black or African American Beneficiaries |
63 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
488 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4035 |