National Provider Identifier [NPI]: |
1578566006 |
Last Name Of The Provider |
BORNO |
First Name Of The Provider |
MOUNIR |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4802 N LOOP 289 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUBBOCK |
Zip Code Of The Provider |
794163025 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
11199 |
Number Of Medicare Beneficiaries |
1937 |
Total Submitted Charge Amount |
3424006.89 |
Total Medicare Allowed Amount |
791145.51 |
Total Medicare Payment Amount |
589583.29 |
Total Medicare Standardized Payment Amount |
616418.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
104 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
13000 |
Total Drug Medicare AllowedAmount |
5525.78 |
Total Drug Medicare PaymentAmount |
4216.87 |
Total Drug Medicare Standardized Payment Amount |
4216.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
110 |
Number Of Medical Services |
11095 |
Number Of Medicare Beneficiaries With Medical Services |
1937 |
Total Medical Submitted Charge Amount |
3411006.89 |
Total Medical Medicare Allowed Amount |
785619.73 |
Total Medical Medicare Payment Amount |
585366.42 |
Total Medical Medicare Standardized Payment Amount |
612201.47 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
699 |
Number Of Beneficiaries Age 75 to 84 |
783 |
Number Of Beneficiaries Age Greater 84 |
337 |
Number Of Female Beneficiaries |
991 |
Number Of Male Beneficiaries |
946 |
Number Of Non Hispanic White Beneficiaries |
1637 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
239 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
1688 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
249 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4489 |