National Provider Identifier [NPI]: |
1356317911 |
Last Name Of The Provider |
MARTINEZ-RODRIGUEZ |
First Name Of The Provider |
JUAN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
BAYAMON MEDICAL MALL # 1845 |
Street Address 2 Of The Provider |
CARR #2 ST 209 |
City Of The Provider |
BAYAMON |
Zip Code Of The Provider |
009597200 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
85 |
Number Of Medicare Beneficiaries |
51 |
Total Submitted Charge Amount |
20852.8 |
Total Medicare Allowed Amount |
14593.28 |
Total Medicare Payment Amount |
11081.95 |
Total Medicare Standardized Payment Amount |
13858.24 |
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 |
23 |
Number Of Medical Services |
85 |
Number Of Medicare Beneficiaries With Medical Services |
51 |
Total Medical Submitted Charge Amount |
20852.8 |
Total Medical Medicare Allowed Amount |
14593.28 |
Total Medical Medicare Payment Amount |
11081.95 |
Total Medical Medicare Standardized Payment Amount |
13858.24 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
0 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
51 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
25 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4135 |