National Provider Identifier [NPI]: |
1699900480 |
Last Name Of The Provider |
OCHOA |
First Name Of The Provider |
LYSSA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 DALLAS ST |
Street Address 2 Of The Provider |
STE 200-A |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782051201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
2327 |
Number Of Medicare Beneficiaries |
677 |
Total Submitted Charge Amount |
1020290 |
Total Medicare Allowed Amount |
323706.6 |
Total Medicare Payment Amount |
247409.96 |
Total Medicare Standardized Payment Amount |
271009.51 |
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 |
124 |
Number Of Medical Services |
2327 |
Number Of Medicare Beneficiaries With Medical Services |
677 |
Total Medical Submitted Charge Amount |
1020290 |
Total Medical Medicare Allowed Amount |
323706.6 |
Total Medical Medicare Payment Amount |
247409.96 |
Total Medical Medicare Standardized Payment Amount |
271009.51 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
333 |
Number Of Male Beneficiaries |
344 |
Number Of Non Hispanic White Beneficiaries |
229 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
382 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
354 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
323 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
70 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
3.2 |