National Provider Identifier [NPI]: |
1750302873 |
Last Name Of The Provider |
VIGIL |
First Name Of The Provider |
LUIS |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
430 N MONTE VISTA ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ADA |
Zip Code Of The Provider |
748204610 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
853 |
Number Of Medicare Beneficiaries |
350 |
Total Submitted Charge Amount |
161585 |
Total Medicare Allowed Amount |
94381.28 |
Total Medicare Payment Amount |
72681.19 |
Total Medicare Standardized Payment Amount |
76288.93 |
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 |
25 |
Number Of Medical Services |
853 |
Number Of Medicare Beneficiaries With Medical Services |
350 |
Total Medical Submitted Charge Amount |
161585 |
Total Medical Medicare Allowed Amount |
94381.28 |
Total Medical Medicare Payment Amount |
72681.19 |
Total Medical Medicare Standardized Payment Amount |
76288.93 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
317 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
20 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
206 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8804 |