National Provider Identifier [NPI]: |
1205804911 |
Last Name Of The Provider |
SANCHEZ |
First Name Of The Provider |
MARIO |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
525 S 10TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RAYMONDVILLE |
Zip Code Of The Provider |
785802508 |
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 |
219 |
Number Of Services |
34307 |
Number Of Medicare Beneficiaries |
645 |
Total Submitted Charge Amount |
2975155.06 |
Total Medicare Allowed Amount |
861367.65 |
Total Medicare Payment Amount |
683027.69 |
Total Medicare Standardized Payment Amount |
706722.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
3052 |
Number Of Medicare Beneficiaries With Drug Services |
370 |
Total Drug Submitted ChargeAmount |
125075.01 |
Total Drug Medicare AllowedAmount |
24734.97 |
Total Drug Medicare PaymentAmount |
19895.71 |
Total Drug Medicare Standardized Payment Amount |
19895.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
202 |
Number Of Medical Services |
31255 |
Number Of Medicare Beneficiaries With Medical Services |
645 |
Total Medical Submitted Charge Amount |
2850080.05 |
Total Medical Medicare Allowed Amount |
836632.68 |
Total Medical Medicare Payment Amount |
663131.98 |
Total Medical Medicare Standardized Payment Amount |
686827.15 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
363 |
Number Of Male Beneficiaries |
282 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
497 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
441 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5042 |