National Provider Identifier [NPI]: |
1477756229 |
Last Name Of The Provider |
RUIZ |
First Name Of The Provider |
GRETHEL |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14023 SOUTHWEST FWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUGAR LAND |
Zip Code Of The Provider |
774783550 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
682 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
62499.06 |
Total Medicare Allowed Amount |
45754.66 |
Total Medicare Payment Amount |
35731.3 |
Total Medicare Standardized Payment Amount |
37200.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
2031.06 |
Total Drug Medicare AllowedAmount |
1900.95 |
Total Drug Medicare PaymentAmount |
1861.7 |
Total Drug Medicare Standardized Payment Amount |
1861.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
563 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
60468 |
Total Medical Medicare Allowed Amount |
43853.71 |
Total Medical Medicare Payment Amount |
33869.6 |
Total Medical Medicare Standardized Payment Amount |
35338.46 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.3795 |