National Provider Identifier [NPI]: |
1083681811 |
Last Name Of The Provider |
PERKINS |
First Name Of The Provider |
MATILDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13722 EMBASSY ROW |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
78216 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
296 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
130990.64 |
Total Medicare Allowed Amount |
25745.73 |
Total Medicare Payment Amount |
19276.85 |
Total Medicare Standardized Payment Amount |
19934.81 |
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 |
14 |
Number Of Medical Services |
296 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
130990.64 |
Total Medical Medicare Allowed Amount |
25745.73 |
Total Medical Medicare Payment Amount |
19276.85 |
Total Medical Medicare Standardized Payment Amount |
19934.81 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
94 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
100 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.254 |