National Provider Identifier [NPI]: |
1851320402 |
Last Name Of The Provider |
OBENG |
First Name Of The Provider |
KWAME |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7330 SAN PEDRO |
Street Address 2 Of The Provider |
STE. 405 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782166235 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
2813 |
Number Of Medicare Beneficiaries |
599 |
Total Submitted Charge Amount |
581604 |
Total Medicare Allowed Amount |
284931.54 |
Total Medicare Payment Amount |
221292.56 |
Total Medicare Standardized Payment Amount |
229966.82 |
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 |
2813 |
Number Of Medicare Beneficiaries With Medical Services |
599 |
Total Medical Submitted Charge Amount |
581604 |
Total Medical Medicare Allowed Amount |
284931.54 |
Total Medical Medicare Payment Amount |
221292.56 |
Total Medical Medicare Standardized Payment Amount |
229966.82 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
175 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
281 |
Number Of Non Hispanic White Beneficiaries |
366 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
202 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
419 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
180 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.3937 |