National Provider Identifier [NPI]: |
1043412851 |
Last Name Of The Provider |
GIQUEL |
First Name Of The Provider |
JADELIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
JACKSON MEMORIAL HOSPITAL |
Street Address 2 Of The Provider |
1611 NW 12 TH AVE |
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
33136 |
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 |
44 |
Number Of Services |
127 |
Number Of Medicare Beneficiaries |
88 |
Total Submitted Charge Amount |
232446.5 |
Total Medicare Allowed Amount |
32575.65 |
Total Medicare Payment Amount |
25539.32 |
Total Medicare Standardized Payment Amount |
22350.01 |
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 |
44 |
Number Of Medical Services |
127 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
232446.5 |
Total Medical Medicare Allowed Amount |
32575.65 |
Total Medical Medicare Payment Amount |
25539.32 |
Total Medical Medicare Standardized Payment Amount |
22350.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
42 |
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 |
50 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
|
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.922 |