National Provider Identifier [NPI]: |
1821239583 |
Last Name Of The Provider |
REYES-GUERRERO |
First Name Of The Provider |
EDNA |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3692 E SAM HOUSTON PKWY S |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
PASADENA |
Zip Code Of The Provider |
775053137 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
977 |
Number Of Medicare Beneficiaries |
244 |
Total Submitted Charge Amount |
87497 |
Total Medicare Allowed Amount |
52658.55 |
Total Medicare Payment Amount |
36325.38 |
Total Medicare Standardized Payment Amount |
36360.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
75 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
390 |
Total Drug Medicare AllowedAmount |
137.27 |
Total Drug Medicare PaymentAmount |
104.64 |
Total Drug Medicare Standardized Payment Amount |
104.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
902 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
87107 |
Total Medical Medicare Allowed Amount |
52521.28 |
Total Medical Medicare Payment Amount |
36220.74 |
Total Medical Medicare Standardized Payment Amount |
36256.13 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
146 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
66 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0951 |