National Provider Identifier [NPI]: |
1225023211 |
Last Name Of The Provider |
TENCHAVEZ |
First Name Of The Provider |
ALVIN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12062 AL HIGHWAY 227 |
Street Address 2 Of The Provider |
|
City Of The Provider |
GERALDINE |
Zip Code Of The Provider |
359743562 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
1045 |
Number Of Medicare Beneficiaries |
385 |
Total Submitted Charge Amount |
92892 |
Total Medicare Allowed Amount |
59084.12 |
Total Medicare Payment Amount |
41795.58 |
Total Medicare Standardized Payment Amount |
49149.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
94 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2609 |
Total Drug Medicare AllowedAmount |
1199.71 |
Total Drug Medicare PaymentAmount |
842.2 |
Total Drug Medicare Standardized Payment Amount |
842.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
951 |
Number Of Medicare Beneficiaries With Medical Services |
376 |
Total Medical Submitted Charge Amount |
90283 |
Total Medical Medicare Allowed Amount |
57884.41 |
Total Medical Medicare Payment Amount |
40953.38 |
Total Medical Medicare Standardized Payment Amount |
48306.86 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
238 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
180 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.3924 |