National Provider Identifier [NPI]: |
1023115292 |
Last Name Of The Provider |
VIRLAR |
First Name Of The Provider |
JESUS |
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 |
1302 SOUTH GENERAL MCMULLEN |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782371703 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
832 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
190614.55 |
Total Medicare Allowed Amount |
78434.73 |
Total Medicare Payment Amount |
61242.23 |
Total Medicare Standardized Payment Amount |
63280.75 |
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 |
15 |
Number Of Medical Services |
832 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
190614.55 |
Total Medical Medicare Allowed Amount |
78434.73 |
Total Medical Medicare Payment Amount |
61242.23 |
Total Medical Medicare Standardized Payment Amount |
63280.75 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
117 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.7657 |