National Provider Identifier [NPI]: |
1578789913 |
Last Name Of The Provider |
MIRELES |
First Name Of The Provider |
JESUS |
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 |
6750 E BAYWOOD AVE |
Street Address 2 Of The Provider |
SUITE 401 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852061749 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2590 |
Number Of Medicare Beneficiaries |
698 |
Total Submitted Charge Amount |
558233 |
Total Medicare Allowed Amount |
323702.93 |
Total Medicare Payment Amount |
250513.63 |
Total Medicare Standardized Payment Amount |
253401.68 |
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 |
35 |
Number Of Medical Services |
2590 |
Number Of Medicare Beneficiaries With Medical Services |
698 |
Total Medical Submitted Charge Amount |
558233 |
Total Medical Medicare Allowed Amount |
323702.93 |
Total Medical Medicare Payment Amount |
250513.63 |
Total Medical Medicare Standardized Payment Amount |
253401.68 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
258 |
Number Of Beneficiaries Age 75 to 84 |
265 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
324 |
Number Of Male Beneficiaries |
374 |
Number Of Non Hispanic White Beneficiaries |
618 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
26 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
584 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.383 |