National Provider Identifier [NPI]: |
1437126851 |
Last Name Of The Provider |
HENDRICK |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8401 DATAPOINT DR |
Street Address 2 Of The Provider |
SUITE 600 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782295900 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
1413 |
Number Of Medicare Beneficiaries |
1154 |
Total Submitted Charge Amount |
120997 |
Total Medicare Allowed Amount |
33320.3 |
Total Medicare Payment Amount |
25675.84 |
Total Medicare Standardized Payment Amount |
26846.39 |
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 |
84 |
Number Of Medical Services |
1413 |
Number Of Medicare Beneficiaries With Medical Services |
1154 |
Total Medical Submitted Charge Amount |
120997 |
Total Medical Medicare Allowed Amount |
33320.3 |
Total Medical Medicare Payment Amount |
25675.84 |
Total Medical Medicare Standardized Payment Amount |
26846.39 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
241 |
Number Of Beneficiaries Age 65 to 74 |
352 |
Number Of Beneficiaries Age 75 to 84 |
355 |
Number Of Beneficiaries Age Greater 84 |
206 |
Number Of Female Beneficiaries |
641 |
Number Of Male Beneficiaries |
513 |
Number Of Non Hispanic White Beneficiaries |
607 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
471 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
747 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
407 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.5206 |