National Provider Identifier [NPI]: |
1396778320 |
Last Name Of The Provider |
SHOWING |
First Name Of The Provider |
LIDIA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2101 PEASE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HARLINGEN |
Zip Code Of The Provider |
785508307 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
4974 |
Number Of Medicare Beneficiaries |
1112 |
Total Submitted Charge Amount |
1241870 |
Total Medicare Allowed Amount |
304138.39 |
Total Medicare Payment Amount |
238115.35 |
Total Medicare Standardized Payment Amount |
140976.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
4974 |
Number Of Medicare Beneficiaries With Medical Services |
1112 |
Total Medical Submitted Charge Amount |
1241870 |
Total Medical Medicare Allowed Amount |
304138.39 |
Total Medical Medicare Payment Amount |
238115.35 |
Total Medical Medicare Standardized Payment Amount |
140976.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
236 |
Number Of Beneficiaries Age 65 to 74 |
446 |
Number Of Beneficiaries Age 75 to 84 |
336 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
628 |
Number Of Male Beneficiaries |
484 |
Number Of Non Hispanic White Beneficiaries |
269 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
832 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
450 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
662 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.0861 |