National Provider Identifier [NPI]: |
1114978061 |
Last Name Of The Provider |
GOMEZ |
First Name Of The Provider |
SANTIAGO |
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 |
1415 TULANE AVE |
Street Address 2 Of The Provider |
HC-73 |
City Of The Provider |
NEW ORLEANS |
Zip Code Of The Provider |
701122600 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
328 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
514215 |
Total Medicare Allowed Amount |
50239.85 |
Total Medicare Payment Amount |
38281.43 |
Total Medicare Standardized Payment Amount |
38420.88 |
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 |
77 |
Number Of Medical Services |
328 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
514215 |
Total Medical Medicare Allowed Amount |
50239.85 |
Total Medical Medicare Payment Amount |
38281.43 |
Total Medical Medicare Standardized Payment Amount |
38420.88 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
119 |
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2896 |