National Provider Identifier [NPI]: |
1861509861 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
SEAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7703 FLOYD CURL DR |
Street Address 2 Of The Provider |
MC 7977 |
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 |
408 |
Number Of Medicare Beneficiaries |
140 |
Total Submitted Charge Amount |
67987 |
Total Medicare Allowed Amount |
33615.5 |
Total Medicare Payment Amount |
26198.69 |
Total Medicare Standardized Payment Amount |
27092.96 |
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 |
408 |
Number Of Medicare Beneficiaries With Medical Services |
140 |
Total Medical Submitted Charge Amount |
67987 |
Total Medical Medicare Allowed Amount |
33615.5 |
Total Medical Medicare Payment Amount |
26198.69 |
Total Medical Medicare Standardized Payment Amount |
27092.96 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
56 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
73 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.9317 |