National Provider Identifier [NPI]: |
1609846682 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
PEDRO |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
141 INDUSTRIAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AZLE |
Zip Code Of The Provider |
760202901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
1855 |
Number Of Medicare Beneficiaries |
596 |
Total Submitted Charge Amount |
1416814 |
Total Medicare Allowed Amount |
307794.13 |
Total Medicare Payment Amount |
223519.36 |
Total Medicare Standardized Payment Amount |
237366.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
230 |
Number Of Medicare Beneficiaries With Drug Services |
96 |
Total Drug Submitted ChargeAmount |
7815 |
Total Drug Medicare AllowedAmount |
2664.22 |
Total Drug Medicare PaymentAmount |
2379.06 |
Total Drug Medicare Standardized Payment Amount |
2379.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1625 |
Number Of Medicare Beneficiaries With Medical Services |
596 |
Total Medical Submitted Charge Amount |
1408999 |
Total Medical Medicare Allowed Amount |
305129.91 |
Total Medical Medicare Payment Amount |
221140.3 |
Total Medical Medicare Standardized Payment Amount |
234987.44 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
278 |
Number Of Non Hispanic White Beneficiaries |
527 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
491 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0932 |