National Provider Identifier [NPI]: |
1407914039 |
Last Name Of The Provider |
SALGUEIRO |
First Name Of The Provider |
CARLOS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
208 NORTH 5TH STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLYTHEVILLE |
Zip Code Of The Provider |
72315 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
303 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
40530.58 |
Total Medicare Allowed Amount |
18939.89 |
Total Medicare Payment Amount |
13468.41 |
Total Medicare Standardized Payment Amount |
14590.23 |
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 |
6 |
Number Of Medical Services |
303 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
40530.58 |
Total Medical Medicare Allowed Amount |
18939.89 |
Total Medical Medicare Payment Amount |
13468.41 |
Total Medical Medicare Standardized Payment Amount |
14590.23 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
131 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
38 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5782 |