National Provider Identifier [NPI]: |
1003809286 |
Last Name Of The Provider |
CABILING |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
635 DITTMER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PUEBLO |
Zip Code Of The Provider |
810051211 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
227 |
Number Of Medicare Beneficiaries |
103 |
Total Submitted Charge Amount |
16429.88 |
Total Medicare Allowed Amount |
16427.92 |
Total Medicare Payment Amount |
12855.14 |
Total Medicare Standardized Payment Amount |
12902.59 |
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 |
2 |
Number Of Medical Services |
227 |
Number Of Medicare Beneficiaries With Medical Services |
103 |
Total Medical Submitted Charge Amount |
16429.88 |
Total Medical Medicare Allowed Amount |
16427.92 |
Total Medical Medicare Payment Amount |
12855.14 |
Total Medical Medicare Standardized Payment Amount |
12902.59 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
49 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
68 |
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 |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
32 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
1.9462 |