National Provider Identifier [NPI]: |
1487620175 |
Last Name Of The Provider |
BRAVERMAN |
First Name Of The Provider |
SHELDON |
Middle Initial Of The Provider |
P |
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 |
782124701 |
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 |
41 |
Number Of Services |
4309 |
Number Of Medicare Beneficiaries |
641 |
Total Submitted Charge Amount |
1511436 |
Total Medicare Allowed Amount |
614230.43 |
Total Medicare Payment Amount |
464207.56 |
Total Medicare Standardized Payment Amount |
485231.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
542 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
572620 |
Total Drug Medicare AllowedAmount |
276918.01 |
Total Drug Medicare PaymentAmount |
216030.99 |
Total Drug Medicare Standardized Payment Amount |
216030.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
3767 |
Number Of Medicare Beneficiaries With Medical Services |
641 |
Total Medical Submitted Charge Amount |
938816 |
Total Medical Medicare Allowed Amount |
337312.42 |
Total Medical Medicare Payment Amount |
248176.57 |
Total Medical Medicare Standardized Payment Amount |
269200.72 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
209 |
Number Of Beneficiaries Age 75 to 84 |
250 |
Number Of Beneficiaries Age Greater 84 |
170 |
Number Of Female Beneficiaries |
385 |
Number Of Male Beneficiaries |
256 |
Number Of Non Hispanic White Beneficiaries |
432 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
185 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
580 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2475 |