National Provider Identifier [NPI]: |
1295720787 |
Last Name Of The Provider |
GUERRA |
First Name Of The Provider |
LUIS |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
911 MEDICAL CENTRE DR STE C |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760124758 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
3085 |
Number Of Medicare Beneficiaries |
661 |
Total Submitted Charge Amount |
743073 |
Total Medicare Allowed Amount |
284537.19 |
Total Medicare Payment Amount |
220194.73 |
Total Medicare Standardized Payment Amount |
223202.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
665 |
Total Drug Medicare AllowedAmount |
423.08 |
Total Drug Medicare PaymentAmount |
414.64 |
Total Drug Medicare Standardized Payment Amount |
414.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
3073 |
Number Of Medicare Beneficiaries With Medical Services |
661 |
Total Medical Submitted Charge Amount |
742408 |
Total Medical Medicare Allowed Amount |
284114.11 |
Total Medical Medicare Payment Amount |
219780.09 |
Total Medical Medicare Standardized Payment Amount |
222788.02 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
212 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
385 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
533 |
Number Of Black or African American Beneficiaries |
64 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
498 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
163 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.4402 |