National Provider Identifier [NPI]: |
1003916511 |
Last Name Of The Provider |
OSONMA |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7330 SAN PEDRO AVE |
Street Address 2 Of The Provider |
STE. 405 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782166235 |
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 |
15 |
Number Of Services |
2476 |
Number Of Medicare Beneficiaries |
591 |
Total Submitted Charge Amount |
514498 |
Total Medicare Allowed Amount |
249070.16 |
Total Medicare Payment Amount |
192597.19 |
Total Medicare Standardized Payment Amount |
201389.5 |
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 |
15 |
Number Of Medical Services |
2476 |
Number Of Medicare Beneficiaries With Medical Services |
591 |
Total Medical Submitted Charge Amount |
514498 |
Total Medical Medicare Allowed Amount |
249070.16 |
Total Medical Medicare Payment Amount |
192597.19 |
Total Medical Medicare Standardized Payment Amount |
201389.5 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
175 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
315 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
366 |
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 |
443 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
148 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.2463 |