National Provider Identifier [NPI]: |
1255301347 |
Last Name Of The Provider |
ADOLFO |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5785 S FORT APACHE RD |
Street Address 2 Of The Provider |
STE. 100B |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891485659 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
2634 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
702959.48 |
Total Medicare Allowed Amount |
252262.26 |
Total Medicare Payment Amount |
184960.51 |
Total Medicare Standardized Payment Amount |
182899.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
245 |
Number Of Medicare Beneficiaries With Drug Services |
180 |
Total Drug Submitted ChargeAmount |
8364 |
Total Drug Medicare AllowedAmount |
3770.96 |
Total Drug Medicare PaymentAmount |
3664.84 |
Total Drug Medicare Standardized Payment Amount |
3664.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
2389 |
Number Of Medicare Beneficiaries With Medical Services |
527 |
Total Medical Submitted Charge Amount |
694595.48 |
Total Medical Medicare Allowed Amount |
248491.3 |
Total Medical Medicare Payment Amount |
181295.67 |
Total Medical Medicare Standardized Payment Amount |
179234.55 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
156 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
258 |
Number Of Black or African American Beneficiaries |
46 |
Number Of AsianPacific Islander Beneficiaries |
110 |
Number Of Hispanic Beneficiaries |
87 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
419 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6221 |