National Provider Identifier [NPI]: |
1588878367 |
Last Name Of The Provider |
MORALES |
First Name Of The Provider |
CARLOS |
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 |
311 CAMDEN ST |
Street Address 2 Of The Provider |
SUITE 208 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782152012 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
171 |
Number Of Services |
13829 |
Number Of Medicare Beneficiaries |
2194 |
Total Submitted Charge Amount |
1098766.74 |
Total Medicare Allowed Amount |
265509.25 |
Total Medicare Payment Amount |
201296.65 |
Total Medicare Standardized Payment Amount |
218153.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
10564 |
Number Of Medicare Beneficiaries With Drug Services |
180 |
Total Drug Submitted ChargeAmount |
16648.74 |
Total Drug Medicare AllowedAmount |
4713.33 |
Total Drug Medicare PaymentAmount |
3505.05 |
Total Drug Medicare Standardized Payment Amount |
3505.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
168 |
Number Of Medical Services |
3265 |
Number Of Medicare Beneficiaries With Medical Services |
2193 |
Total Medical Submitted Charge Amount |
1082118 |
Total Medical Medicare Allowed Amount |
260795.92 |
Total Medical Medicare Payment Amount |
197791.6 |
Total Medical Medicare Standardized Payment Amount |
214648.46 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
560 |
Number Of Beneficiaries Age 65 to 74 |
748 |
Number Of Beneficiaries Age 75 to 84 |
569 |
Number Of Beneficiaries Age Greater 84 |
317 |
Number Of Female Beneficiaries |
1270 |
Number Of Male Beneficiaries |
924 |
Number Of Non Hispanic White Beneficiaries |
910 |
Number Of Black or African American Beneficiaries |
213 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
1036 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1258 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
936 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.6557 |