National Provider Identifier [NPI]: |
1427252089 |
Last Name Of The Provider |
GARCIA-GALLEGOS |
First Name Of The Provider |
JESUS |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
720 PLEASANTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782141306 |
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 |
96 |
Number Of Services |
2490 |
Number Of Medicare Beneficiaries |
370 |
Total Submitted Charge Amount |
363840 |
Total Medicare Allowed Amount |
156430.08 |
Total Medicare Payment Amount |
117858.28 |
Total Medicare Standardized Payment Amount |
124351.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
246 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
2057.75 |
Total Drug Medicare AllowedAmount |
761.81 |
Total Drug Medicare PaymentAmount |
725.4 |
Total Drug Medicare Standardized Payment Amount |
725.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
86 |
Number Of Medical Services |
2244 |
Number Of Medicare Beneficiaries With Medical Services |
370 |
Total Medical Submitted Charge Amount |
361782.25 |
Total Medical Medicare Allowed Amount |
155668.27 |
Total Medical Medicare Payment Amount |
117132.88 |
Total Medical Medicare Standardized Payment Amount |
123625.98 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
73 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
273 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.7377 |