National Provider Identifier [NPI]: |
1497782551 |
Last Name Of The Provider |
JIMENEZ |
First Name Of The Provider |
HARRY |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
BB 28 SANTA JUANITA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAYAMON |
Zip Code Of The Provider |
00956 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
2165 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
157998.38 |
Total Medicare Allowed Amount |
126170.08 |
Total Medicare Payment Amount |
92130.16 |
Total Medicare Standardized Payment Amount |
86776.28 |
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 |
12 |
Number Of Medical Services |
2165 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
157998.38 |
Total Medical Medicare Allowed Amount |
126170.08 |
Total Medical Medicare Payment Amount |
92130.16 |
Total Medical Medicare Standardized Payment Amount |
86776.28 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9907 |