| National Provider Identifier [NPI]: | 1184614927 |
| Last Name Of The Provider | BLONDET |
| First Name Of The Provider | MAXIMO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD,FCCP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 AVE FD ROOSEVELT |
| Street Address 2 Of The Provider | EDIF CLINICA LAS AMERICAS OFIC 205 |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 009182103 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1345 |
| Number Of Medicare Beneficiaries | 420 |
| Total Submitted Charge Amount | 178232.86 |
| Total Medicare Allowed Amount | 178000.22 |
| Total Medicare Payment Amount | 135625.53 |
| Total Medicare Standardized Payment Amount | 163583.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 469.69 |
| Total Drug Medicare AllowedAmount | 464.25 |
| Total Drug Medicare PaymentAmount | 454.93 |
| Total Drug Medicare Standardized Payment Amount | 454.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1310 |
| Number Of Medicare Beneficiaries With Medical Services | 420 |
| Total Medical Submitted Charge Amount | 177763.17 |
| Total Medical Medicare Allowed Amount | 177535.97 |
| Total Medical Medicare Payment Amount | 135170.6 |
| Total Medical Medicare Standardized Payment Amount | 163128.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 404 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 74 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.4115 |