National Provider Identifier [NPI]: |
1477758399 |
Last Name Of The Provider |
GOMEZ-URENA |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1532 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
190911 |
Total Medicare Allowed Amount |
106250.11 |
Total Medicare Payment Amount |
82514.54 |
Total Medicare Standardized Payment Amount |
87663.18 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
259 |
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 |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
61 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8528 |