National Provider Identifier [NPI]: |
1891739892 |
Last Name Of The Provider |
RAIMER |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
301 UNIVERSITY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GALVESTON |
Zip Code Of The Provider |
775555302 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
4331 |
Number Of Medicare Beneficiaries |
693 |
Total Submitted Charge Amount |
591463 |
Total Medicare Allowed Amount |
141793.37 |
Total Medicare Payment Amount |
100784.34 |
Total Medicare Standardized Payment Amount |
99822.36 |
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 |
46 |
Number Of Medical Services |
4331 |
Number Of Medicare Beneficiaries With Medical Services |
693 |
Total Medical Submitted Charge Amount |
591463 |
Total Medical Medicare Allowed Amount |
141793.37 |
Total Medical Medicare Payment Amount |
100784.34 |
Total Medical Medicare Standardized Payment Amount |
99822.36 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
285 |
Number Of Beneficiaries Age 75 to 84 |
253 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
610 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
646 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0542 |