National Provider Identifier [NPI]: |
1780729137 |
Last Name Of The Provider |
PEREZ |
First Name Of The Provider |
DIEGO |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
NP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
UNIVERSITY OF TOLEDO MEDICAL CENTER |
Street Address 2 Of The Provider |
3000 ARLINGTON |
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
43614 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
1194 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
92469.49 |
Total Medicare Allowed Amount |
89208.96 |
Total Medicare Payment Amount |
69087.99 |
Total Medicare Standardized Payment Amount |
87191.35 |
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 |
9 |
Number Of Medical Services |
1194 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
92469.49 |
Total Medical Medicare Allowed Amount |
89208.96 |
Total Medical Medicare Payment Amount |
69087.99 |
Total Medical Medicare Standardized Payment Amount |
87191.35 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
299 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.1224 |