National Provider Identifier [NPI]: |
1922052570 |
Last Name Of The Provider |
FEUILLET |
First Name Of The Provider |
PABLO |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
155 E SONTERRA BLVD. |
Street Address 2 Of The Provider |
SUITE #111 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782583988 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1069 |
Number Of Medicare Beneficiaries |
297 |
Total Submitted Charge Amount |
245543 |
Total Medicare Allowed Amount |
137943.29 |
Total Medicare Payment Amount |
105766.83 |
Total Medicare Standardized Payment Amount |
110421.98 |
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 |
15 |
Number Of Medical Services |
1069 |
Number Of Medicare Beneficiaries With Medical Services |
297 |
Total Medical Submitted Charge Amount |
245543 |
Total Medical Medicare Allowed Amount |
137943.29 |
Total Medical Medicare Payment Amount |
105766.83 |
Total Medical Medicare Standardized Payment Amount |
110421.98 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
139 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
203 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.9186 |