National Provider Identifier [NPI]: |
1275581423 |
Last Name Of The Provider |
AGUILAR |
First Name Of The Provider |
ERNESTO |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 N WILMOT RD |
Street Address 2 Of The Provider |
#A110 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857124416 |
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 |
161 |
Number Of Services |
4966 |
Number Of Medicare Beneficiaries |
286 |
Total Submitted Charge Amount |
265038 |
Total Medicare Allowed Amount |
137873.38 |
Total Medicare Payment Amount |
103866.1 |
Total Medicare Standardized Payment Amount |
106162.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
1161 |
Number Of Medicare Beneficiaries With Drug Services |
107 |
Total Drug Submitted ChargeAmount |
15391 |
Total Drug Medicare AllowedAmount |
6085.77 |
Total Drug Medicare PaymentAmount |
5699.68 |
Total Drug Medicare Standardized Payment Amount |
5699.68 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
148 |
Number Of Medical Services |
3805 |
Number Of Medicare Beneficiaries With Medical Services |
286 |
Total Medical Submitted Charge Amount |
249647 |
Total Medical Medicare Allowed Amount |
131787.61 |
Total Medical Medicare Payment Amount |
98166.42 |
Total Medical Medicare Standardized Payment Amount |
100462.74 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
220 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9402 |