National Provider Identifier [NPI]: |
1861402604 |
Last Name Of The Provider |
POTEET |
First Name Of The Provider |
ROBYN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7703 FLOYD CURL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293901 |
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 |
575 |
Number Of Medicare Beneficiaries |
203 |
Total Submitted Charge Amount |
114185 |
Total Medicare Allowed Amount |
56860.63 |
Total Medicare Payment Amount |
43509.78 |
Total Medicare Standardized Payment Amount |
45500.5 |
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 |
575 |
Number Of Medicare Beneficiaries With Medical Services |
203 |
Total Medical Submitted Charge Amount |
114185 |
Total Medical Medicare Allowed Amount |
56860.63 |
Total Medical Medicare Payment Amount |
43509.78 |
Total Medical Medicare Standardized Payment Amount |
45500.5 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
78 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
111 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
93 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
3.4775 |