Medicare Facts for Dr. Edward S. Ellis, MD


National Provider Identifier [NPI]: 1750348199
Last Name Of The Provider ELLIS
First Name Of The Provider EDWARD
Middle Initial Of The Provider
Credentials Of The Provider DDS MS
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 MC 7908
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 Oral Surgery (dentists only)
Medicare Participation Indicator Y
Number Of HCPCS 21
Number Of Services 38
Number Of Medicare Beneficiaries 18
Total Submitted Charge Amount 31428
Total Medicare Allowed Amount 6533.06
Total Medicare Payment Amount 5018.69
Total Medicare Standardized Payment Amount 5288.05
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 38
Number Of Medicare Beneficiaries With Medical Services 18
Total Medical Submitted Charge Amount 31428
Total Medical Medicare Allowed Amount 6533.06
Total Medical Medicare Payment Amount 5018.69
Total Medical Medicare Standardized Payment Amount 5288.05
Average Age Of Beneficiaries 65
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries
Number Of Male Beneficiaries
Number Of Non Hispanic White Beneficiaries
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries 0
Number Of Hispanic Beneficiaries
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma
Percent Of With Cancer 0
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression
Percent Of With Diabetes
Percent Of With Hyperlipidemia
Percent Of With Hypertension
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 1.0337

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