National Provider Identifier [NPI]: |
1275581068 |
Last Name Of The Provider |
DO |
First Name Of The Provider |
HAO |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
DPM, PC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1850 HUNTER DR. |
Street Address 2 Of The Provider |
STE. 107 |
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799151549 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1119 |
Number Of Medicare Beneficiaries |
403 |
Total Submitted Charge Amount |
91600 |
Total Medicare Allowed Amount |
85883.71 |
Total Medicare Payment Amount |
66164.01 |
Total Medicare Standardized Payment Amount |
69899.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
250 |
Total Drug Medicare AllowedAmount |
141.94 |
Total Drug Medicare PaymentAmount |
111.29 |
Total Drug Medicare Standardized Payment Amount |
111.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1094 |
Number Of Medicare Beneficiaries With Medical Services |
403 |
Total Medical Submitted Charge Amount |
91350 |
Total Medical Medicare Allowed Amount |
85741.77 |
Total Medical Medicare Payment Amount |
66052.72 |
Total Medical Medicare Standardized Payment Amount |
69788.31 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
249 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
71 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
317 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
222 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.9765 |