National Provider Identifier [NPI]: |
1588641377 |
Last Name Of The Provider |
VAZQUEZ |
First Name Of The Provider |
SALVADOR |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1055 ADA ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782231703 |
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 |
7 |
Number Of Services |
457 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
64166.48 |
Total Medicare Allowed Amount |
32087.35 |
Total Medicare Payment Amount |
20921.51 |
Total Medicare Standardized Payment Amount |
21797.15 |
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 |
7 |
Number Of Medical Services |
457 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
64166.48 |
Total Medical Medicare Allowed Amount |
32087.35 |
Total Medical Medicare Payment Amount |
20921.51 |
Total Medical Medicare Standardized Payment Amount |
21797.15 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
22 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
129 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3093 |