National Provider Identifier [NPI]: |
1861496630 |
Last Name Of The Provider |
TSAI |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
343 W HOUSTON ST |
Street Address 2 Of The Provider |
STE 109 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782052262 |
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 |
25 |
Number Of Services |
455 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
86735 |
Total Medicare Allowed Amount |
60658.87 |
Total Medicare Payment Amount |
42798.58 |
Total Medicare Standardized Payment Amount |
45683.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
455 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
86735 |
Total Medical Medicare Allowed Amount |
60658.87 |
Total Medical Medicare Payment Amount |
42798.58 |
Total Medical Medicare Standardized Payment Amount |
45683.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
82 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
89 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7261 |