National Provider Identifier [NPI]: |
1730167479 |
Last Name Of The Provider |
BAGG |
First Name Of The Provider |
MARK |
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 |
21 SPURS LN |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782401669 |
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 |
134 |
Number Of Services |
3675 |
Number Of Medicare Beneficiaries |
542 |
Total Submitted Charge Amount |
686229.5 |
Total Medicare Allowed Amount |
261040.03 |
Total Medicare Payment Amount |
192340.41 |
Total Medicare Standardized Payment Amount |
206925.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1560 |
Number Of Medicare Beneficiaries With Drug Services |
224 |
Total Drug Submitted ChargeAmount |
51102.5 |
Total Drug Medicare AllowedAmount |
32043.64 |
Total Drug Medicare PaymentAmount |
25029.43 |
Total Drug Medicare Standardized Payment Amount |
25029.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
131 |
Number Of Medical Services |
2115 |
Number Of Medicare Beneficiaries With Medical Services |
542 |
Total Medical Submitted Charge Amount |
635127 |
Total Medical Medicare Allowed Amount |
228996.39 |
Total Medical Medicare Payment Amount |
167310.98 |
Total Medical Medicare Standardized Payment Amount |
181896.13 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
320 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
407 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
114 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
503 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1079 |