National Provider Identifier [NPI]: |
1083876858 |
Last Name Of The Provider |
VANCE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 E BEAUREGARD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANGELO |
Zip Code Of The Provider |
769027200 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
380 |
Number Of Medicare Beneficiaries |
282 |
Total Submitted Charge Amount |
96052.47 |
Total Medicare Allowed Amount |
91752.16 |
Total Medicare Payment Amount |
70787.67 |
Total Medicare Standardized Payment Amount |
74029.75 |
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 |
87 |
Number Of Medical Services |
380 |
Number Of Medicare Beneficiaries With Medical Services |
282 |
Total Medical Submitted Charge Amount |
96052.47 |
Total Medical Medicare Allowed Amount |
91752.16 |
Total Medical Medicare Payment Amount |
70787.67 |
Total Medical Medicare Standardized Payment Amount |
74029.75 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
215 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4055 |