National Provider Identifier [NPI]: |
1962443812 |
Last Name Of The Provider |
MASZAK |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6800 W IH 10 |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782012038 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
563 |
Number Of Medicare Beneficiaries |
251 |
Total Submitted Charge Amount |
431722 |
Total Medicare Allowed Amount |
145350.73 |
Total Medicare Payment Amount |
112382.9 |
Total Medicare Standardized Payment Amount |
120095.36 |
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 |
29 |
Number Of Medical Services |
563 |
Number Of Medicare Beneficiaries With Medical Services |
251 |
Total Medical Submitted Charge Amount |
431722 |
Total Medical Medicare Allowed Amount |
145350.73 |
Total Medical Medicare Payment Amount |
112382.9 |
Total Medical Medicare Standardized Payment Amount |
120095.36 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
85 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
144 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.5158 |