National Provider Identifier [NPI]: |
1003827692 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
ARMANDO |
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 |
395 N SILVERBELL RD |
Street Address 2 Of The Provider |
#265 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857452675 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1257 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
138440 |
Total Medicare Allowed Amount |
106710.28 |
Total Medicare Payment Amount |
73677.04 |
Total Medicare Standardized Payment Amount |
79054.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
122 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
980 |
Total Drug Medicare AllowedAmount |
537.85 |
Total Drug Medicare PaymentAmount |
472.85 |
Total Drug Medicare Standardized Payment Amount |
472.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
1135 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
137460 |
Total Medical Medicare Allowed Amount |
106172.43 |
Total Medical Medicare Payment Amount |
73204.19 |
Total Medical Medicare Standardized Payment Amount |
78581.69 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
97 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
130 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3113 |