National Provider Identifier [NPI]: |
1851357024 |
Last Name Of The Provider |
RAMIREZ |
First Name Of The Provider |
GRACIA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 DALLAS ST |
Street Address 2 Of The Provider |
EMERGENCY ROOM |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782051201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1155 |
Number Of Medicare Beneficiaries |
670 |
Total Submitted Charge Amount |
524497.77 |
Total Medicare Allowed Amount |
112707.64 |
Total Medicare Payment Amount |
86731.69 |
Total Medicare Standardized Payment Amount |
89271.38 |
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 |
35 |
Number Of Medical Services |
1155 |
Number Of Medicare Beneficiaries With Medical Services |
670 |
Total Medical Submitted Charge Amount |
524497.77 |
Total Medical Medicare Allowed Amount |
112707.64 |
Total Medical Medicare Payment Amount |
86731.69 |
Total Medical Medicare Standardized Payment Amount |
89271.38 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
204 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
406 |
Number Of Male Beneficiaries |
264 |
Number Of Non Hispanic White Beneficiaries |
358 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
238 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
433 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
237 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2125 |