National Provider Identifier [NPI]: |
1013957265 |
Last Name Of The Provider |
CUNNINGHAM |
First Name Of The Provider |
STEPHEN |
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 |
4085 DE ZAVALA RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SHAVANO PARK |
Zip Code Of The Provider |
782492084 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1254 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
375910 |
Total Medicare Allowed Amount |
43147.3 |
Total Medicare Payment Amount |
33747.47 |
Total Medicare Standardized Payment Amount |
28968.08 |
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 |
1254 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
375910 |
Total Medical Medicare Allowed Amount |
43147.3 |
Total Medical Medicare Payment Amount |
33747.47 |
Total Medical Medicare Standardized Payment Amount |
28968.08 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
220 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
319 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
141 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
400 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6928 |