National Provider Identifier [NPI]: |
1407844004 |
Last Name Of The Provider |
RUIZ |
First Name Of The Provider |
VERONICA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2214 E 29TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992033939 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
3793 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
254765.18 |
Total Medicare Allowed Amount |
90982.41 |
Total Medicare Payment Amount |
74189.3 |
Total Medicare Standardized Payment Amount |
74629.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
297 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
1857.26 |
Total Drug Medicare AllowedAmount |
854.85 |
Total Drug Medicare PaymentAmount |
811.61 |
Total Drug Medicare Standardized Payment Amount |
811.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
114 |
Number Of Medical Services |
3496 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
252907.92 |
Total Medical Medicare Allowed Amount |
90127.56 |
Total Medical Medicare Payment Amount |
73377.69 |
Total Medical Medicare Standardized Payment Amount |
73817.42 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
167 |
Number Of Black or African American Beneficiaries |
|
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 |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9398 |