National Provider Identifier [NPI]: |
1396739173 |
Last Name Of The Provider |
BORRON |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4801 ALBERTA AVE |
Street Address 2 Of The Provider |
SUITE B3200 |
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799052707 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
149 |
Number Of Medicare Beneficiaries |
137 |
Total Submitted Charge Amount |
47765.57 |
Total Medicare Allowed Amount |
17675.56 |
Total Medicare Payment Amount |
12985.04 |
Total Medicare Standardized Payment Amount |
13397.33 |
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 |
9 |
Number Of Medical Services |
149 |
Number Of Medicare Beneficiaries With Medical Services |
137 |
Total Medical Submitted Charge Amount |
47765.57 |
Total Medical Medicare Allowed Amount |
17675.56 |
Total Medical Medicare Payment Amount |
12985.04 |
Total Medical Medicare Standardized Payment Amount |
13397.33 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
66 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
110 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0471 |