National Provider Identifier [NPI]: |
1457659013 |
Last Name Of The Provider |
DIAZ-GONZALEZ |
First Name Of The Provider |
ANA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9159 SW 87TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331762302 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
644 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
64901 |
Total Medicare Allowed Amount |
39475.69 |
Total Medicare Payment Amount |
30308.58 |
Total Medicare Standardized Payment Amount |
28671.64 |
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 |
25 |
Number Of Medical Services |
644 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
64901 |
Total Medical Medicare Allowed Amount |
39475.69 |
Total Medical Medicare Payment Amount |
30308.58 |
Total Medical Medicare Standardized Payment Amount |
28671.64 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
21 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
155 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
31 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
52 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6858 |