| National Provider Identifier [NPI]: | 1003059080 |
| Last Name Of The Provider | CUBILLOS |
| First Name Of The Provider | NORA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16400 BLANCO RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782321902 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 828 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 153537.61 |
| Total Medicare Allowed Amount | 60017.62 |
| Total Medicare Payment Amount | 46906.58 |
| Total Medicare Standardized Payment Amount | 48567.34 |
| 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 | 7 |
| Number Of Medical Services | 828 |
| Number Of Medicare Beneficiaries With Medical Services | 177 |
| Total Medical Submitted Charge Amount | 153537.61 |
| Total Medical Medicare Allowed Amount | 60017.62 |
| Total Medical Medicare Payment Amount | 46906.58 |
| Total Medical Medicare Standardized Payment Amount | 48567.34 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | 117 |
| Number Of Black or African American Beneficiaries | |
| 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 | 131 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 57 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 59 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 23 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2967 |