National Provider Identifier [NPI]: |
1063528263 |
Last Name Of The Provider |
HARTSON |
First Name Of The Provider |
REID |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 CONCORD PLAZA DR |
Street Address 2 Of The Provider |
SUITE 510 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782166943 |
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 |
20 |
Number Of Services |
1117 |
Number Of Medicare Beneficiaries |
339 |
Total Submitted Charge Amount |
243760 |
Total Medicare Allowed Amount |
117037.67 |
Total Medicare Payment Amount |
91040.42 |
Total Medicare Standardized Payment Amount |
93955.63 |
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 |
20 |
Number Of Medical Services |
1117 |
Number Of Medicare Beneficiaries With Medical Services |
339 |
Total Medical Submitted Charge Amount |
243760 |
Total Medical Medicare Allowed Amount |
117037.67 |
Total Medical Medicare Payment Amount |
91040.42 |
Total Medical Medicare Standardized Payment Amount |
93955.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
191 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
233 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.6434 |