National Provider Identifier [NPI]: |
1750371365 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
JOAQUIN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 MACARTHUR BLVD |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212915 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
3686 |
Number Of Medicare Beneficiaries |
1201 |
Total Submitted Charge Amount |
1844633.48 |
Total Medicare Allowed Amount |
469705.14 |
Total Medicare Payment Amount |
356815.58 |
Total Medicare Standardized Payment Amount |
369814.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
202 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
39186.48 |
Total Drug Medicare AllowedAmount |
9164.64 |
Total Drug Medicare PaymentAmount |
7185.23 |
Total Drug Medicare Standardized Payment Amount |
7185.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
110 |
Number Of Medical Services |
3484 |
Number Of Medicare Beneficiaries With Medical Services |
1201 |
Total Medical Submitted Charge Amount |
1805447 |
Total Medical Medicare Allowed Amount |
460540.5 |
Total Medical Medicare Payment Amount |
349630.35 |
Total Medical Medicare Standardized Payment Amount |
362629.66 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
409 |
Number Of Beneficiaries Age 75 to 84 |
416 |
Number Of Beneficiaries Age Greater 84 |
249 |
Number Of Female Beneficiaries |
695 |
Number Of Male Beneficiaries |
506 |
Number Of Non Hispanic White Beneficiaries |
1013 |
Number Of Black or African American Beneficiaries |
90 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
87 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1069 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9212 |