National Provider Identifier [NPI]: |
1689654170 |
Last Name Of The Provider |
RAINOSEK |
First Name Of The Provider |
DELBERT |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4085 DE ZAVALA RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SHAVANO PARK |
Zip Code Of The Provider |
782492084 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1682 |
Number Of Medicare Beneficiaries |
529 |
Total Submitted Charge Amount |
554170 |
Total Medicare Allowed Amount |
72665.8 |
Total Medicare Payment Amount |
56952.15 |
Total Medicare Standardized Payment Amount |
39457.39 |
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 |
17 |
Number Of Medical Services |
1682 |
Number Of Medicare Beneficiaries With Medical Services |
529 |
Total Medical Submitted Charge Amount |
554170 |
Total Medical Medicare Allowed Amount |
72665.8 |
Total Medical Medicare Payment Amount |
56952.15 |
Total Medical Medicare Standardized Payment Amount |
39457.39 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
330 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
354 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
149 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
453 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4635 |