National Provider Identifier [NPI]: |
1376843755 |
Last Name Of The Provider |
ARA |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2601 HOSPITAL BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784051804 |
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 |
43 |
Number Of Services |
646 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
92145 |
Total Medicare Allowed Amount |
44129.29 |
Total Medicare Payment Amount |
32054.9 |
Total Medicare Standardized Payment Amount |
33837.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
82 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
2603 |
Total Drug Medicare AllowedAmount |
1565.93 |
Total Drug Medicare PaymentAmount |
1521.99 |
Total Drug Medicare Standardized Payment Amount |
1521.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
564 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
89542 |
Total Medical Medicare Allowed Amount |
42563.36 |
Total Medical Medicare Payment Amount |
30532.91 |
Total Medical Medicare Standardized Payment Amount |
32315.74 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
99 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
128 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8554 |