National Provider Identifier [NPI]: |
1033220744 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
MIGUEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
33025 PROFESSIONAL DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEESBURG |
Zip Code Of The Provider |
34788 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
123275 |
Number Of Medicare Beneficiaries |
1431 |
Total Submitted Charge Amount |
3193087.46 |
Total Medicare Allowed Amount |
2682743.02 |
Total Medicare Payment Amount |
2090230 |
Total Medicare Standardized Payment Amount |
2088182.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
116344 |
Number Of Medicare Beneficiaries With Drug Services |
473 |
Total Drug Submitted ChargeAmount |
2463595 |
Total Drug Medicare AllowedAmount |
2112729.13 |
Total Drug Medicare PaymentAmount |
1647249.64 |
Total Drug Medicare Standardized Payment Amount |
1647249.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
6931 |
Number Of Medicare Beneficiaries With Medical Services |
1431 |
Total Medical Submitted Charge Amount |
729492.46 |
Total Medical Medicare Allowed Amount |
570013.89 |
Total Medical Medicare Payment Amount |
442980.36 |
Total Medical Medicare Standardized Payment Amount |
440933.13 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
638 |
Number Of Beneficiaries Age 75 to 84 |
600 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
977 |
Number Of Male Beneficiaries |
454 |
Number Of Non Hispanic White Beneficiaries |
1332 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1376 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4471 |