National Provider Identifier [NPI]: |
1447235908 |
Last Name Of The Provider |
SMOLENS |
First Name Of The Provider |
PETER |
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 |
2391 NE LOOP 410 |
Street Address 2 Of The Provider |
SUITE 405 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782175600 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
5119 |
Number Of Medicare Beneficiaries |
464 |
Total Submitted Charge Amount |
616928 |
Total Medicare Allowed Amount |
306000.95 |
Total Medicare Payment Amount |
235142.22 |
Total Medicare Standardized Payment Amount |
246036.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
564 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
12440 |
Total Drug Medicare AllowedAmount |
6481.02 |
Total Drug Medicare PaymentAmount |
5093.21 |
Total Drug Medicare Standardized Payment Amount |
5093.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
4555 |
Number Of Medicare Beneficiaries With Medical Services |
464 |
Total Medical Submitted Charge Amount |
604488 |
Total Medical Medicare Allowed Amount |
299519.93 |
Total Medical Medicare Payment Amount |
230049.01 |
Total Medical Medicare Standardized Payment Amount |
240943.49 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
256 |
Number Of Non Hispanic White Beneficiaries |
283 |
Number Of Black or African American Beneficiaries |
69 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
101 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
361 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.6056 |