National Provider Identifier [NPI]: |
1457356461 |
Last Name Of The Provider |
DIAZ |
First Name Of The Provider |
LUIS |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
653 N TOWN CENTER DR |
Street Address 2 Of The Provider |
STE 312 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891440520 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
60174 |
Number Of Medicare Beneficiaries |
624 |
Total Submitted Charge Amount |
3019195.39 |
Total Medicare Allowed Amount |
1225194.21 |
Total Medicare Payment Amount |
923103.45 |
Total Medicare Standardized Payment Amount |
901777.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
57518 |
Number Of Medicare Beneficiaries With Drug Services |
69 |
Total Drug Submitted ChargeAmount |
2450125.79 |
Total Drug Medicare AllowedAmount |
956534.39 |
Total Drug Medicare PaymentAmount |
731387.8 |
Total Drug Medicare Standardized Payment Amount |
731387.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
2656 |
Number Of Medicare Beneficiaries With Medical Services |
624 |
Total Medical Submitted Charge Amount |
569069.6 |
Total Medical Medicare Allowed Amount |
268659.82 |
Total Medical Medicare Payment Amount |
191715.65 |
Total Medical Medicare Standardized Payment Amount |
170389.79 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
253 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
383 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
421 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
122 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
514 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3338 |