National Provider Identifier [NPI]: |
1871502120 |
Last Name Of The Provider |
BERMUDEZ |
First Name Of The Provider |
YURI |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 W SAM HOUSTON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHARR |
Zip Code Of The Provider |
785775104 |
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 |
57 |
Number Of Services |
2938 |
Number Of Medicare Beneficiaries |
513 |
Total Submitted Charge Amount |
316619.46 |
Total Medicare Allowed Amount |
200221.23 |
Total Medicare Payment Amount |
138825.83 |
Total Medicare Standardized Payment Amount |
138910.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
29 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1265 |
Total Drug Medicare AllowedAmount |
291.49 |
Total Drug Medicare PaymentAmount |
283.26 |
Total Drug Medicare Standardized Payment Amount |
283.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2909 |
Number Of Medicare Beneficiaries With Medical Services |
513 |
Total Medical Submitted Charge Amount |
315354.46 |
Total Medical Medicare Allowed Amount |
199929.74 |
Total Medical Medicare Payment Amount |
138542.57 |
Total Medical Medicare Standardized Payment Amount |
138627.12 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
195 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
227 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
262 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
223 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7675 |