National Provider Identifier [NPI]: |
1841371515 |
Last Name Of The Provider |
MENDEZ |
First Name Of The Provider |
RICARDO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN, FNP-BC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
38719 MILE 7 RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PENITAS |
Zip Code Of The Provider |
785767507 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
516 |
Number Of Medicare Beneficiaries |
26 |
Total Submitted Charge Amount |
32250 |
Total Medicare Allowed Amount |
16933.6 |
Total Medicare Payment Amount |
13041.86 |
Total Medicare Standardized Payment Amount |
15887.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
167 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
7025 |
Total Drug Medicare AllowedAmount |
244.73 |
Total Drug Medicare PaymentAmount |
191.96 |
Total Drug Medicare Standardized Payment Amount |
191.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
349 |
Number Of Medicare Beneficiaries With Medical Services |
26 |
Total Medical Submitted Charge Amount |
25225 |
Total Medical Medicare Allowed Amount |
16688.87 |
Total Medical Medicare Payment Amount |
12849.9 |
Total Medical Medicare Standardized Payment Amount |
15695.19 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
0 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5985 |