National Provider Identifier [NPI]: |
1396741104 |
Last Name Of The Provider |
MALDONADO |
First Name Of The Provider |
YASMIN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 UPTOWN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROWNSVILLE |
Zip Code Of The Provider |
785207559 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
6639 |
Number Of Medicare Beneficiaries |
504 |
Total Submitted Charge Amount |
748493.92 |
Total Medicare Allowed Amount |
393400.44 |
Total Medicare Payment Amount |
293216.26 |
Total Medicare Standardized Payment Amount |
308184.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
449 |
Number Of Medicare Beneficiaries With Drug Services |
298 |
Total Drug Submitted ChargeAmount |
22070 |
Total Drug Medicare AllowedAmount |
13554.13 |
Total Drug Medicare PaymentAmount |
13264.72 |
Total Drug Medicare Standardized Payment Amount |
13264.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
6190 |
Number Of Medicare Beneficiaries With Medical Services |
504 |
Total Medical Submitted Charge Amount |
726423.92 |
Total Medical Medicare Allowed Amount |
379846.31 |
Total Medical Medicare Payment Amount |
279951.54 |
Total Medical Medicare Standardized Payment Amount |
294920.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
466 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
104 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
400 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
26 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6392 |