National Provider Identifier [NPI]: |
1811983679 |
Last Name Of The Provider |
FUENMAYOR |
First Name Of The Provider |
JOAQUIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11760 SW 40TH ST |
Street Address 2 Of The Provider |
557 |
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331753582 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
759 |
Number Of Medicare Beneficiaries |
339 |
Total Submitted Charge Amount |
195990 |
Total Medicare Allowed Amount |
127843.91 |
Total Medicare Payment Amount |
99560.29 |
Total Medicare Standardized Payment Amount |
84824.47 |
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 |
17 |
Number Of Medical Services |
759 |
Number Of Medicare Beneficiaries With Medical Services |
339 |
Total Medical Submitted Charge Amount |
195990 |
Total Medical Medicare Allowed Amount |
127843.91 |
Total Medical Medicare Payment Amount |
99560.29 |
Total Medical Medicare Standardized Payment Amount |
84824.47 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
304 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
273 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4703 |