National Provider Identifier [NPI]: |
1902856438 |
Last Name Of The Provider |
QUINTERO |
First Name Of The Provider |
JESUS |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2161 E COMMERCIAL BLVD |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
FT LAUDERDALE |
Zip Code Of The Provider |
333083810 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
1323 |
Number Of Medicare Beneficiaries |
213 |
Total Submitted Charge Amount |
299288.38 |
Total Medicare Allowed Amount |
232678.16 |
Total Medicare Payment Amount |
178814.53 |
Total Medicare Standardized Payment Amount |
170936.03 |
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 |
11 |
Number Of Medical Services |
1323 |
Number Of Medicare Beneficiaries With Medical Services |
213 |
Total Medical Submitted Charge Amount |
299288.38 |
Total Medical Medicare Allowed Amount |
232678.16 |
Total Medical Medicare Payment Amount |
178814.53 |
Total Medical Medicare Standardized Payment Amount |
170936.03 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
71 |
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
4.2344 |