National Provider Identifier [NPI]: |
1639162746 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4411 E SOUTHCROSS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782223726 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
96 |
Number Of Services |
25158.5 |
Number Of Medicare Beneficiaries |
482 |
Total Submitted Charge Amount |
955270.59 |
Total Medicare Allowed Amount |
659405.73 |
Total Medicare Payment Amount |
552660.45 |
Total Medicare Standardized Payment Amount |
524853.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
866.5 |
Number Of Medicare Beneficiaries With Drug Services |
343 |
Total Drug Submitted ChargeAmount |
14432.07 |
Total Drug Medicare AllowedAmount |
12769.53 |
Total Drug Medicare PaymentAmount |
11901.82 |
Total Drug Medicare Standardized Payment Amount |
11901.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
85 |
Number Of Medical Services |
24292 |
Number Of Medicare Beneficiaries With Medical Services |
482 |
Total Medical Submitted Charge Amount |
940838.52 |
Total Medical Medicare Allowed Amount |
646636.2 |
Total Medical Medicare Payment Amount |
540758.63 |
Total Medical Medicare Standardized Payment Amount |
512951.19 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
276 |
Number Of Male Beneficiaries |
206 |
Number Of Non Hispanic White Beneficiaries |
322 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
89 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
429 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.5595 |