National Provider Identifier [NPI]: |
1356493977 |
Last Name Of The Provider |
BENAVIDES |
First Name Of The Provider |
OSCAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
209 W VILLAGE BLVD |
Street Address 2 Of The Provider |
STE 3 |
City Of The Provider |
LAREDO |
Zip Code Of The Provider |
780412227 |
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 |
87 |
Number Of Services |
4695 |
Number Of Medicare Beneficiaries |
797 |
Total Submitted Charge Amount |
538514.26 |
Total Medicare Allowed Amount |
212471.38 |
Total Medicare Payment Amount |
144987.69 |
Total Medicare Standardized Payment Amount |
147151.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
987 |
Number Of Medicare Beneficiaries With Drug Services |
224 |
Total Drug Submitted ChargeAmount |
24495 |
Total Drug Medicare AllowedAmount |
1015.73 |
Total Drug Medicare PaymentAmount |
835.9 |
Total Drug Medicare Standardized Payment Amount |
835.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
3708 |
Number Of Medicare Beneficiaries With Medical Services |
797 |
Total Medical Submitted Charge Amount |
514019.26 |
Total Medical Medicare Allowed Amount |
211455.65 |
Total Medical Medicare Payment Amount |
144151.79 |
Total Medical Medicare Standardized Payment Amount |
146315.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
342 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
459 |
Number Of Male Beneficiaries |
338 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
625 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
370 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
427 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2086 |