National Provider Identifier [NPI]: |
1518083062 |
Last Name Of The Provider |
CARTER |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 LONE STAR PASS |
Street Address 2 Of The Provider |
BLDG 46 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782643638 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
401 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
204607.02 |
Total Medicare Allowed Amount |
37783.08 |
Total Medicare Payment Amount |
28860.22 |
Total Medicare Standardized Payment Amount |
29689.92 |
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 |
21 |
Number Of Medical Services |
401 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
204607.02 |
Total Medical Medicare Allowed Amount |
37783.08 |
Total Medical Medicare Payment Amount |
28860.22 |
Total Medical Medicare Standardized Payment Amount |
29689.92 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
195 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2754 |