National Provider Identifier [NPI]: |
1083691810 |
Last Name Of The Provider |
VELEZ |
First Name Of The Provider |
JORGE |
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 |
8401 DATAPOINT DR STE 600 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782295907 |
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 |
243 |
Number Of Services |
18773 |
Number Of Medicare Beneficiaries |
6060 |
Total Submitted Charge Amount |
1895587.5 |
Total Medicare Allowed Amount |
513929.56 |
Total Medicare Payment Amount |
398910.35 |
Total Medicare Standardized Payment Amount |
429018.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
9600 |
Number Of Medicare Beneficiaries With Drug Services |
98 |
Total Drug Submitted ChargeAmount |
6492.5 |
Total Drug Medicare AllowedAmount |
2871.73 |
Total Drug Medicare PaymentAmount |
2251.29 |
Total Drug Medicare Standardized Payment Amount |
2251.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
240 |
Number Of Medical Services |
9173 |
Number Of Medicare Beneficiaries With Medical Services |
6060 |
Total Medical Submitted Charge Amount |
1889095 |
Total Medical Medicare Allowed Amount |
511057.83 |
Total Medical Medicare Payment Amount |
396659.06 |
Total Medical Medicare Standardized Payment Amount |
426767.35 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
1156 |
Number Of Beneficiaries Age 65 to 74 |
2101 |
Number Of Beneficiaries Age 75 to 84 |
1778 |
Number Of Beneficiaries Age Greater 84 |
1025 |
Number Of Female Beneficiaries |
3294 |
Number Of Male Beneficiaries |
2766 |
Number Of Non Hispanic White Beneficiaries |
3415 |
Number Of Black or African American Beneficiaries |
299 |
Number Of AsianPacific Islander Beneficiaries |
58 |
Number Of Hispanic Beneficiaries |
2239 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
4306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1754 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.3166 |