National Provider Identifier [NPI]: |
1831109354 |
Last Name Of The Provider |
RODRIGUEZ |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7703 FLOYD CURL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
647 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
43026 |
Total Medicare Allowed Amount |
25667.65 |
Total Medicare Payment Amount |
16460.95 |
Total Medicare Standardized Payment Amount |
21678.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
49 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1210 |
Total Drug Medicare AllowedAmount |
124.34 |
Total Drug Medicare PaymentAmount |
100.95 |
Total Drug Medicare Standardized Payment Amount |
100.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
598 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
41816 |
Total Medical Medicare Allowed Amount |
25543.31 |
Total Medical Medicare Payment Amount |
16360 |
Total Medical Medicare Standardized Payment Amount |
21577.73 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
51 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
117 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
55 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1893 |