| National Provider Identifier [NPI]: | 1609929405 |
| Last Name Of The Provider | HERNANDEZ |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9765 SAN JOSE BLVD |
| Street Address 2 Of The Provider | STE. 102 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322574402 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 5678 |
| Number Of Medicare Beneficiaries | 758 |
| Total Submitted Charge Amount | 610364.96 |
| Total Medicare Allowed Amount | 422112.07 |
| Total Medicare Payment Amount | 311387 |
| Total Medicare Standardized Payment Amount | 313460.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1038 |
| Total Drug Medicare AllowedAmount | 182.09 |
| Total Drug Medicare PaymentAmount | 169.84 |
| Total Drug Medicare Standardized Payment Amount | 169.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 5645 |
| Number Of Medicare Beneficiaries With Medical Services | 758 |
| Total Medical Submitted Charge Amount | 609326.96 |
| Total Medical Medicare Allowed Amount | 421929.98 |
| Total Medical Medicare Payment Amount | 311217.16 |
| Total Medical Medicare Standardized Payment Amount | 313290.57 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 216 |
| Number Of Beneficiaries Age Greater 84 | 309 |
| Number Of Female Beneficiaries | 503 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 647 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 234 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 57 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9407 |