| National Provider Identifier [NPI]: | 1689653917 |
| Last Name Of The Provider | CUEVAS |
| First Name Of The Provider | RITA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 215 E QUINCY ST |
| Street Address 2 Of The Provider | SUITE 417 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782152039 |
| 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 | 16 |
| Number Of Services | 1119 |
| Number Of Medicare Beneficiaries | 448 |
| Total Submitted Charge Amount | 130045.06 |
| Total Medicare Allowed Amount | 107839.06 |
| Total Medicare Payment Amount | 74705.33 |
| Total Medicare Standardized Payment Amount | 80101.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 505.05 |
| Total Drug Medicare AllowedAmount | 100.08 |
| Total Drug Medicare PaymentAmount | 73.83 |
| Total Drug Medicare Standardized Payment Amount | 73.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1081 |
| Number Of Medicare Beneficiaries With Medical Services | 448 |
| Total Medical Submitted Charge Amount | 129540.01 |
| Total Medical Medicare Allowed Amount | 107738.98 |
| Total Medical Medicare Payment Amount | 74631.5 |
| Total Medical Medicare Standardized Payment Amount | 80027.45 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 373 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 84 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 333 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 243 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 205 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4403 |