National Provider Identifier [NPI]: |
1093717639 |
Last Name Of The Provider |
MAYMI |
First Name Of The Provider |
JOSE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
844 CENTRAL BLVD |
Street Address 2 Of The Provider |
SUITE 430 |
City Of The Provider |
BROWNSVILLE |
Zip Code Of The Provider |
785207552 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
7362 |
Number Of Medicare Beneficiaries |
1036 |
Total Submitted Charge Amount |
1506559 |
Total Medicare Allowed Amount |
463944.99 |
Total Medicare Payment Amount |
344463.64 |
Total Medicare Standardized Payment Amount |
362779.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
779 |
Number Of Medicare Beneficiaries With Drug Services |
62 |
Total Drug Submitted ChargeAmount |
319517 |
Total Drug Medicare AllowedAmount |
50584.98 |
Total Drug Medicare PaymentAmount |
39212.78 |
Total Drug Medicare Standardized Payment Amount |
39212.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
6583 |
Number Of Medicare Beneficiaries With Medical Services |
1036 |
Total Medical Submitted Charge Amount |
1187042 |
Total Medical Medicare Allowed Amount |
413360.01 |
Total Medical Medicare Payment Amount |
305250.86 |
Total Medical Medicare Standardized Payment Amount |
323566.78 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
398 |
Number Of Beneficiaries Age 75 to 84 |
354 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
750 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
916 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
317 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
719 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7015 |