National Provider Identifier [NPI]: |
1700018991 |
Last Name Of The Provider |
TOMACRUZ |
First Name Of The Provider |
YVETTE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1126 SLIDE RD |
Street Address 2 Of The Provider |
SUITE 4-B |
City Of The Provider |
LUBBOCK |
Zip Code Of The Provider |
794165402 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
9788 |
Number Of Medicare Beneficiaries |
901 |
Total Submitted Charge Amount |
1488252 |
Total Medicare Allowed Amount |
777440.71 |
Total Medicare Payment Amount |
591175.04 |
Total Medicare Standardized Payment Amount |
628450.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
5984 |
Number Of Medicare Beneficiaries With Drug Services |
102 |
Total Drug Submitted ChargeAmount |
14868 |
Total Drug Medicare AllowedAmount |
1344.29 |
Total Drug Medicare PaymentAmount |
1040.1 |
Total Drug Medicare Standardized Payment Amount |
1040.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
3804 |
Number Of Medicare Beneficiaries With Medical Services |
901 |
Total Medical Submitted Charge Amount |
1473384 |
Total Medical Medicare Allowed Amount |
776096.42 |
Total Medical Medicare Payment Amount |
590134.94 |
Total Medical Medicare Standardized Payment Amount |
627409.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
235 |
Number Of Beneficiaries Age 65 to 74 |
293 |
Number Of Beneficiaries Age 75 to 84 |
253 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
468 |
Number Of Male Beneficiaries |
433 |
Number Of Non Hispanic White Beneficiaries |
473 |
Number Of Black or African American Beneficiaries |
75 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
332 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
606 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
295 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.8382 |