National Provider Identifier [NPI]: |
1053515619 |
Last Name Of The Provider |
GOMEZ |
First Name Of The Provider |
ADRIANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4418 N. MCCOLL ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MCALLEN |
Zip Code Of The Provider |
78504 |
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 |
28 |
Number Of Services |
3414 |
Number Of Medicare Beneficiaries |
1265 |
Total Submitted Charge Amount |
692619 |
Total Medicare Allowed Amount |
330586.15 |
Total Medicare Payment Amount |
258043.31 |
Total Medicare Standardized Payment Amount |
266971.98 |
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 |
28 |
Number Of Medical Services |
3414 |
Number Of Medicare Beneficiaries With Medical Services |
1265 |
Total Medical Submitted Charge Amount |
692619 |
Total Medical Medicare Allowed Amount |
330586.15 |
Total Medical Medicare Payment Amount |
258043.31 |
Total Medical Medicare Standardized Payment Amount |
266971.98 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
225 |
Number Of Beneficiaries Age 65 to 74 |
327 |
Number Of Beneficiaries Age 75 to 84 |
402 |
Number Of Beneficiaries Age Greater 84 |
311 |
Number Of Female Beneficiaries |
703 |
Number Of Male Beneficiaries |
562 |
Number Of Non Hispanic White Beneficiaries |
279 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
974 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
413 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
852 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
45 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.3836 |