National Provider Identifier [NPI]: |
1235112285 |
Last Name Of The Provider |
PEREZ |
First Name Of The Provider |
ABIMAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 MORGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784051805 |
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 |
34 |
Number Of Services |
483 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
41368 |
Total Medicare Allowed Amount |
27521.09 |
Total Medicare Payment Amount |
18008.33 |
Total Medicare Standardized Payment Amount |
19231.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
112 |
Total Drug Medicare AllowedAmount |
49 |
Total Drug Medicare PaymentAmount |
40.12 |
Total Drug Medicare Standardized Payment Amount |
40.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
449 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
41256 |
Total Medical Medicare Allowed Amount |
27472.09 |
Total Medical Medicare Payment Amount |
17968.21 |
Total Medical Medicare Standardized Payment Amount |
19190.98 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
171 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8644 |