National Provider Identifier [NPI]: |
1952381063 |
Last Name Of The Provider |
HUDNALL |
First Name Of The Provider |
CLAYTON |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7909 FREDERICKSBURG RD |
Street Address 2 Of The Provider |
SUITE #125 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293425 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
8349 |
Number Of Medicare Beneficiaries |
1108 |
Total Submitted Charge Amount |
827424.43 |
Total Medicare Allowed Amount |
325076.93 |
Total Medicare Payment Amount |
240214.34 |
Total Medicare Standardized Payment Amount |
253498.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
1820 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
142209.5 |
Total Drug Medicare AllowedAmount |
52345.57 |
Total Drug Medicare PaymentAmount |
37349.8 |
Total Drug Medicare Standardized Payment Amount |
37349.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
6529 |
Number Of Medicare Beneficiaries With Medical Services |
1108 |
Total Medical Submitted Charge Amount |
685214.93 |
Total Medical Medicare Allowed Amount |
272731.36 |
Total Medical Medicare Payment Amount |
202864.54 |
Total Medical Medicare Standardized Payment Amount |
216148.76 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
485 |
Number Of Beneficiaries Age 75 to 84 |
397 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
875 |
Number Of Non Hispanic White Beneficiaries |
799 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
257 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1019 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2235 |