National Provider Identifier [NPI]: |
1114126919 |
Last Name Of The Provider |
SANCHEZ |
First Name Of The Provider |
JAIME |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 TAMPA GENERAL CIR |
Street Address 2 Of The Provider |
STC 3RD FLOOR |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336063603 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
273 |
Number Of Medicare Beneficiaries |
106 |
Total Submitted Charge Amount |
313399 |
Total Medicare Allowed Amount |
96610.97 |
Total Medicare Payment Amount |
74609.12 |
Total Medicare Standardized Payment Amount |
72899.36 |
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 |
80 |
Number Of Medical Services |
273 |
Number Of Medicare Beneficiaries With Medical Services |
106 |
Total Medical Submitted Charge Amount |
313399 |
Total Medical Medicare Allowed Amount |
96610.97 |
Total Medical Medicare Payment Amount |
74609.12 |
Total Medical Medicare Standardized Payment Amount |
72899.36 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
89 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
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 |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
37 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6337 |