National Provider Identifier [NPI]: |
1104013499 |
Last Name Of The Provider |
MURILLO |
First Name Of The Provider |
CARLOS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1315 ST JOSEPH PKWY |
Street Address 2 Of The Provider |
SUITE 1602 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770028233 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
756 |
Number Of Medicare Beneficiaries |
178 |
Total Submitted Charge Amount |
296840 |
Total Medicare Allowed Amount |
141097.93 |
Total Medicare Payment Amount |
109915.02 |
Total Medicare Standardized Payment Amount |
105209.08 |
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 |
91 |
Number Of Medical Services |
756 |
Number Of Medicare Beneficiaries With Medical Services |
178 |
Total Medical Submitted Charge Amount |
296840 |
Total Medical Medicare Allowed Amount |
141097.93 |
Total Medical Medicare Payment Amount |
109915.02 |
Total Medical Medicare Standardized Payment Amount |
105209.08 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
51 |
Number Of Black or African American Beneficiaries |
93 |
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 |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
4.3522 |