| National Provider Identifier [NPI]: | 1710966361 |
| Last Name Of The Provider | JARAMILLO-DOLAN |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 6TH ST NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINTER HAVEN |
| Zip Code Of The Provider | 338814630 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 6521 |
| Number Of Medicare Beneficiaries | 901 |
| Total Submitted Charge Amount | 526808.89 |
| Total Medicare Allowed Amount | 398290.29 |
| Total Medicare Payment Amount | 285695.5 |
| Total Medicare Standardized Payment Amount | 291359.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 536 |
| Number Of Medicare Beneficiaries With Drug Services | 152 |
| Total Drug Submitted ChargeAmount | 1151.66 |
| Total Drug Medicare AllowedAmount | 954.86 |
| Total Drug Medicare PaymentAmount | 703.31 |
| Total Drug Medicare Standardized Payment Amount | 703.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 5985 |
| Number Of Medicare Beneficiaries With Medical Services | 901 |
| Total Medical Submitted Charge Amount | 525657.23 |
| Total Medical Medicare Allowed Amount | 397335.43 |
| Total Medical Medicare Payment Amount | 284992.19 |
| Total Medical Medicare Standardized Payment Amount | 290656.5 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 380 |
| Number Of Beneficiaries Age 75 to 84 | 328 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 498 |
| Number Of Male Beneficiaries | 403 |
| Number Of Non Hispanic White Beneficiaries | 794 |
| Number Of Black or African American Beneficiaries | 52 |
| 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 | 821 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5878 |