National Provider Identifier [NPI]: |
1861468530 |
Last Name Of The Provider |
OEI |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 N MAIN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
78212 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
39254 |
Number Of Medicare Beneficiaries |
1457 |
Total Submitted Charge Amount |
6785192 |
Total Medicare Allowed Amount |
3115892.06 |
Total Medicare Payment Amount |
2371280.3 |
Total Medicare Standardized Payment Amount |
2514703.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
10705 |
Number Of Medicare Beneficiaries With Drug Services |
457 |
Total Drug Submitted ChargeAmount |
1688760 |
Total Drug Medicare AllowedAmount |
840448.59 |
Total Drug Medicare PaymentAmount |
656057.35 |
Total Drug Medicare Standardized Payment Amount |
656057.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
28549 |
Number Of Medicare Beneficiaries With Medical Services |
1457 |
Total Medical Submitted Charge Amount |
5096432 |
Total Medical Medicare Allowed Amount |
2275443.47 |
Total Medical Medicare Payment Amount |
1715222.95 |
Total Medical Medicare Standardized Payment Amount |
1858645.97 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
475 |
Number Of Beneficiaries Age 75 to 84 |
556 |
Number Of Beneficiaries Age Greater 84 |
360 |
Number Of Female Beneficiaries |
862 |
Number Of Male Beneficiaries |
595 |
Number Of Non Hispanic White Beneficiaries |
1243 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
190 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3367 |