National Provider Identifier [NPI]: |
1366634420 |
Last Name Of The Provider |
GUIDO |
First Name Of The Provider |
HUGO |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7121 S PADRE ISLAND DR |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784124938 |
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 |
23 |
Number Of Services |
431 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
107094.63 |
Total Medicare Allowed Amount |
48355.24 |
Total Medicare Payment Amount |
35020.87 |
Total Medicare Standardized Payment Amount |
37044.62 |
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 |
23 |
Number Of Medical Services |
431 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
107094.63 |
Total Medical Medicare Allowed Amount |
48355.24 |
Total Medical Medicare Payment Amount |
35020.87 |
Total Medical Medicare Standardized Payment Amount |
37044.62 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
120 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.6907 |