National Provider Identifier [NPI]: |
1568740843 |
Last Name Of The Provider |
GAMEZ |
First Name Of The Provider |
WILFREDO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 VAN BUREN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANNAPOLIS |
Zip Code Of The Provider |
214032124 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
2254 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
201006.62 |
Total Medicare Allowed Amount |
198153.57 |
Total Medicare Payment Amount |
155039.51 |
Total Medicare Standardized Payment Amount |
143910.45 |
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 |
10 |
Number Of Medical Services |
2254 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
201006.62 |
Total Medical Medicare Allowed Amount |
198153.57 |
Total Medical Medicare Payment Amount |
155039.51 |
Total Medical Medicare Standardized Payment Amount |
143910.45 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
161 |
Number Of Black or African American Beneficiaries |
169 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
182 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
52 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
31 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
4.1543 |