National Provider Identifier [NPI]: |
1376651349 |
Last Name Of The Provider |
MCINTOSH |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2501 BUENA VISTA DR SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALBUQUERQUE |
Zip Code Of The Provider |
871064260 |
State Code Of The Provider |
NM |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
606 |
Number Of Medicare Beneficiaries |
197 |
Total Submitted Charge Amount |
55039 |
Total Medicare Allowed Amount |
44123.17 |
Total Medicare Payment Amount |
31124.21 |
Total Medicare Standardized Payment Amount |
32304.4 |
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 |
8 |
Number Of Medical Services |
606 |
Number Of Medicare Beneficiaries With Medical Services |
197 |
Total Medical Submitted Charge Amount |
55039 |
Total Medical Medicare Allowed Amount |
44123.17 |
Total Medical Medicare Payment Amount |
31124.21 |
Total Medical Medicare Standardized Payment Amount |
32304.4 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
67 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.287 |