National Provider Identifier [NPI]: |
1366627523 |
Last Name Of The Provider |
CANTU |
First Name Of The Provider |
JOSE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6807 EMMETT F LOWRY EXPY |
Street Address 2 Of The Provider |
#303 |
City Of The Provider |
TEXAS CITY |
Zip Code Of The Provider |
775912546 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
5378 |
Number Of Medicare Beneficiaries |
893 |
Total Submitted Charge Amount |
975001.37 |
Total Medicare Allowed Amount |
540233.69 |
Total Medicare Payment Amount |
415199.45 |
Total Medicare Standardized Payment Amount |
414087.86 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
305 |
Number Of Beneficiaries Age 75 to 84 |
275 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
479 |
Number Of Male Beneficiaries |
414 |
Number Of Non Hispanic White Beneficiaries |
622 |
Number Of Black or African American Beneficiaries |
168 |
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
631 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
262 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.8894 |