National Provider Identifier [NPI]: |
1437358108 |
Last Name Of The Provider |
SEGURA |
First Name Of The Provider |
SUSANA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1755 HERITAGE TRL |
Street Address 2 Of The Provider |
|
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341127600 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
81 |
Number Of Medicare Beneficiaries |
42 |
Total Submitted Charge Amount |
1898 |
Total Medicare Allowed Amount |
1102.85 |
Total Medicare Payment Amount |
950.99 |
Total Medicare Standardized Payment Amount |
1275.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
33 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
878 |
Total Drug Medicare AllowedAmount |
352.41 |
Total Drug Medicare PaymentAmount |
345.41 |
Total Drug Medicare Standardized Payment Amount |
345.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
3 |
Number Of Medical Services |
48 |
Number Of Medicare Beneficiaries With Medical Services |
42 |
Total Medical Submitted Charge Amount |
1020 |
Total Medical Medicare Allowed Amount |
750.44 |
Total Medical Medicare Payment Amount |
605.58 |
Total Medical Medicare Standardized Payment Amount |
930.02 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
17 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
27 |
Number Of Male Beneficiaries |
15 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0443 |