National Provider Identifier [NPI]: |
1245269240 |
Last Name Of The Provider |
HOA |
First Name Of The Provider |
DON |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1611 NW 12TH AVE |
Street Address 2 Of The Provider |
BOX 016960 (M851) |
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331361005 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
504 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
513222.5 |
Total Medicare Allowed Amount |
62494.83 |
Total Medicare Payment Amount |
47865.11 |
Total Medicare Standardized Payment Amount |
41802.28 |
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 |
17 |
Number Of Medical Services |
504 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
513222.5 |
Total Medical Medicare Allowed Amount |
62494.83 |
Total Medical Medicare Payment Amount |
47865.11 |
Total Medical Medicare Standardized Payment Amount |
41802.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
212 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
230 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
196 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.6355 |