| National Provider Identifier [NPI]: | 1255312245 |
| Last Name Of The Provider | SEPULVEDA |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17270 RED OAK DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770902632 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurosurgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 1547 |
| Number Of Medicare Beneficiaries | 294 |
| Total Submitted Charge Amount | 444138.5 |
| Total Medicare Allowed Amount | 125079 |
| Total Medicare Payment Amount | 91729.58 |
| Total Medicare Standardized Payment Amount | 92525.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 365 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 6356 |
| Total Drug Medicare AllowedAmount | 4684.33 |
| Total Drug Medicare PaymentAmount | 3645.56 |
| Total Drug Medicare Standardized Payment Amount | 3645.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1182 |
| Number Of Medicare Beneficiaries With Medical Services | 294 |
| Total Medical Submitted Charge Amount | 437782.5 |
| Total Medical Medicare Allowed Amount | 120394.67 |
| Total Medical Medicare Payment Amount | 88084.02 |
| Total Medical Medicare Standardized Payment Amount | 88879.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 216 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 242 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.201 |