National Provider Identifier [NPI]: |
1760563381 |
Last Name Of The Provider |
GOMEZ |
First Name Of The Provider |
JAIME |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3270 JOE BATTLE BLVD STE 360 |
Street Address 2 Of The Provider |
|
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799382656 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
864 |
Number Of Medicare Beneficiaries |
348 |
Total Submitted Charge Amount |
422019 |
Total Medicare Allowed Amount |
140454.45 |
Total Medicare Payment Amount |
106150.96 |
Total Medicare Standardized Payment Amount |
116630.94 |
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 |
91 |
Number Of Medical Services |
864 |
Number Of Medicare Beneficiaries With Medical Services |
348 |
Total Medical Submitted Charge Amount |
422019 |
Total Medical Medicare Allowed Amount |
140454.45 |
Total Medical Medicare Payment Amount |
106150.96 |
Total Medical Medicare Standardized Payment Amount |
116630.94 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
75 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
254 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.4507 |