National Provider Identifier [NPI]: |
1134162381 |
Last Name Of The Provider |
GARTON |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
19016 STONE OAK PKWY |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782583280 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
703 |
Number Of Medicare Beneficiaries |
149 |
Total Submitted Charge Amount |
138697 |
Total Medicare Allowed Amount |
52881.81 |
Total Medicare Payment Amount |
38351.59 |
Total Medicare Standardized Payment Amount |
41675.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1120 |
Total Drug Medicare AllowedAmount |
183.04 |
Total Drug Medicare PaymentAmount |
144.72 |
Total Drug Medicare Standardized Payment Amount |
144.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
671 |
Number Of Medicare Beneficiaries With Medical Services |
149 |
Total Medical Submitted Charge Amount |
137577 |
Total Medical Medicare Allowed Amount |
52698.77 |
Total Medical Medicare Payment Amount |
38206.87 |
Total Medical Medicare Standardized Payment Amount |
41530.73 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
106 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1478 |