National Provider Identifier [NPI]: |
1659345577 |
Last Name Of The Provider |
CAUDILLO |
First Name Of The Provider |
MAGDALENA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 E NOLANA AVE STE 13A |
Street Address 2 Of The Provider |
|
City Of The Provider |
MCALLEN |
Zip Code Of The Provider |
785046112 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
1792 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
125926 |
Total Medicare Allowed Amount |
35066.44 |
Total Medicare Payment Amount |
26172.91 |
Total Medicare Standardized Payment Amount |
30865.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
269 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
14145 |
Total Drug Medicare AllowedAmount |
219.37 |
Total Drug Medicare PaymentAmount |
186.13 |
Total Drug Medicare Standardized Payment Amount |
186.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1523 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
111781 |
Total Medical Medicare Allowed Amount |
34847.07 |
Total Medical Medicare Payment Amount |
25986.78 |
Total Medical Medicare Standardized Payment Amount |
30679.4 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
14 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
165 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
35 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2456 |