National Provider Identifier [NPI]: |
1811939820 |
Last Name Of The Provider |
CONNOR |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 CONCORD PLAZA DR |
Street Address 2 Of The Provider |
300 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782166905 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
3143 |
Number Of Medicare Beneficiaries |
320 |
Total Submitted Charge Amount |
1031143.88 |
Total Medicare Allowed Amount |
269828.02 |
Total Medicare Payment Amount |
200360.56 |
Total Medicare Standardized Payment Amount |
206379.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1057 |
Number Of Medicare Beneficiaries With Drug Services |
155 |
Total Drug Submitted ChargeAmount |
166810.4 |
Total Drug Medicare AllowedAmount |
56457.99 |
Total Drug Medicare PaymentAmount |
43815.86 |
Total Drug Medicare Standardized Payment Amount |
43815.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
2086 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
864333.48 |
Total Medical Medicare Allowed Amount |
213370.03 |
Total Medical Medicare Payment Amount |
156544.7 |
Total Medical Medicare Standardized Payment Amount |
162563.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
86 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1217 |