National Provider Identifier [NPI]: |
1255341061 |
Last Name Of The Provider |
SILVA |
First Name Of The Provider |
SERGIO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
207 TRADEWINDS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDLAND |
Zip Code Of The Provider |
797062807 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
1518 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
205538 |
Total Medicare Allowed Amount |
129510.48 |
Total Medicare Payment Amount |
100791.89 |
Total Medicare Standardized Payment Amount |
103842.04 |
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 |
8 |
Number Of Medical Services |
1518 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
205538 |
Total Medical Medicare Allowed Amount |
129510.48 |
Total Medical Medicare Payment Amount |
100791.89 |
Total Medical Medicare Standardized Payment Amount |
103842.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
162 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
62 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
57 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5243 |