National Provider Identifier [NPI]: |
1063492692 |
Last Name Of The Provider |
KARDOS |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9600 DATAPOINT DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782292028 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
812 |
Number Of Medicare Beneficiaries |
303 |
Total Submitted Charge Amount |
167435 |
Total Medicare Allowed Amount |
52363.69 |
Total Medicare Payment Amount |
40687.86 |
Total Medicare Standardized Payment Amount |
37783.79 |
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 |
19 |
Number Of Medical Services |
812 |
Number Of Medicare Beneficiaries With Medical Services |
303 |
Total Medical Submitted Charge Amount |
167435 |
Total Medical Medicare Allowed Amount |
52363.69 |
Total Medical Medicare Payment Amount |
40687.86 |
Total Medical Medicare Standardized Payment Amount |
37783.79 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
143 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
137 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
196 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6559 |