National Provider Identifier [NPI]: |
1407896236 |
Last Name Of The Provider |
VALERO |
First Name Of The Provider |
CELIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2435 W BELVEDERE AVE |
Street Address 2 Of The Provider |
SUITE 22 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212155224 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
883 |
Number Of Medicare Beneficiaries |
404 |
Total Submitted Charge Amount |
170160 |
Total Medicare Allowed Amount |
92018.87 |
Total Medicare Payment Amount |
71668.42 |
Total Medicare Standardized Payment Amount |
68331.53 |
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 |
12 |
Number Of Medical Services |
883 |
Number Of Medicare Beneficiaries With Medical Services |
404 |
Total Medical Submitted Charge Amount |
170160 |
Total Medical Medicare Allowed Amount |
92018.87 |
Total Medical Medicare Payment Amount |
71668.42 |
Total Medical Medicare Standardized Payment Amount |
68331.53 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
253 |
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 |
268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.7317 |