National Provider Identifier [NPI]: |
1720022635 |
Last Name Of The Provider |
FERNANDEZ |
First Name Of The Provider |
HECTOR |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7150 W 20 AVE |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
HIALEAH |
Zip Code Of The Provider |
330165509 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
63 |
Number Of Medicare Beneficiaries |
50 |
Total Submitted Charge Amount |
18070 |
Total Medicare Allowed Amount |
7044.88 |
Total Medicare Payment Amount |
5256.54 |
Total Medicare Standardized Payment Amount |
4755.78 |
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 |
7 |
Number Of Medical Services |
63 |
Number Of Medicare Beneficiaries With Medical Services |
50 |
Total Medical Submitted Charge Amount |
18070 |
Total Medical Medicare Allowed Amount |
7044.88 |
Total Medical Medicare Payment Amount |
5256.54 |
Total Medical Medicare Standardized Payment Amount |
4755.78 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
16 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
0 |
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 |
11 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
44 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1817 |