National Provider Identifier [NPI]: |
1538158050 |
Last Name Of The Provider |
AVILA |
First Name Of The Provider |
FERNANDO |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 S SAINT MARYS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782053435 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
10191 |
Number Of Medicare Beneficiaries |
296 |
Total Submitted Charge Amount |
2028955.4 |
Total Medicare Allowed Amount |
849111.19 |
Total Medicare Payment Amount |
655441.8 |
Total Medicare Standardized Payment Amount |
554429.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
2295 |
Number Of Medicare Beneficiaries With Drug Services |
88 |
Total Drug Submitted ChargeAmount |
75835.4 |
Total Drug Medicare AllowedAmount |
25132.62 |
Total Drug Medicare PaymentAmount |
19265.6 |
Total Drug Medicare Standardized Payment Amount |
19265.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
7896 |
Number Of Medicare Beneficiaries With Medical Services |
296 |
Total Medical Submitted Charge Amount |
1953120 |
Total Medical Medicare Allowed Amount |
823978.57 |
Total Medical Medicare Payment Amount |
636176.2 |
Total Medical Medicare Standardized Payment Amount |
535163.59 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
183 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
114 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
182 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.6756 |