National Provider Identifier [NPI]: |
1245320308 |
Last Name Of The Provider |
CORTES |
First Name Of The Provider |
GIL |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
AVE SEVERIANO CUEVAS |
Street Address 2 Of The Provider |
WESTERN MEDICAL PLAZA, SUITE 19 |
City Of The Provider |
AGUADILLA |
Zip Code Of The Provider |
006035726 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
8168 |
Number Of Medicare Beneficiaries |
1183 |
Total Submitted Charge Amount |
869020 |
Total Medicare Allowed Amount |
512440.28 |
Total Medicare Payment Amount |
374304.52 |
Total Medicare Standardized Payment Amount |
371594.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
652 |
Total Drug Medicare AllowedAmount |
328.87 |
Total Drug Medicare PaymentAmount |
254.13 |
Total Drug Medicare Standardized Payment Amount |
254.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
8084 |
Number Of Medicare Beneficiaries With Medical Services |
1183 |
Total Medical Submitted Charge Amount |
868368 |
Total Medical Medicare Allowed Amount |
512111.41 |
Total Medical Medicare Payment Amount |
374050.39 |
Total Medical Medicare Standardized Payment Amount |
371339.93 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
483 |
Number Of Beneficiaries Age 75 to 84 |
413 |
Number Of Beneficiaries Age Greater 84 |
244 |
Number Of Female Beneficiaries |
578 |
Number Of Male Beneficiaries |
605 |
Number Of Non Hispanic White Beneficiaries |
1152 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1547 |