National Provider Identifier [NPI]: |
1518164698 |
Last Name Of The Provider |
PENARANDA |
First Name Of The Provider |
DEXTER |
Middle Initial Of The Provider |
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Credentials Of The Provider |
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Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5820 HARBORAGE DR |
Street Address 2 Of The Provider |
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City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339084549 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
8205 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
510301.54 |
Total Medicare Allowed Amount |
198805.13 |
Total Medicare Payment Amount |
155349.44 |
Total Medicare Standardized Payment Amount |
118348.47 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
164 |
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
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Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.1405 |