National Provider Identifier [NPI]: |
1053390641 |
Last Name Of The Provider |
SAGARDIA |
First Name Of The Provider |
MIGUEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1613 HARRISON PKWY |
Street Address 2 Of The Provider |
#200 |
City Of The Provider |
SUNRISE |
Zip Code Of The Provider |
333232853 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
381 |
Number Of Medicare Beneficiaries |
255 |
Total Submitted Charge Amount |
177064 |
Total Medicare Allowed Amount |
38106.59 |
Total Medicare Payment Amount |
28812.77 |
Total Medicare Standardized Payment Amount |
27269.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
638 |
Total Drug Medicare AllowedAmount |
284.8 |
Total Drug Medicare PaymentAmount |
229.83 |
Total Drug Medicare Standardized Payment Amount |
229.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
369 |
Number Of Medicare Beneficiaries With Medical Services |
255 |
Total Medical Submitted Charge Amount |
176426 |
Total Medical Medicare Allowed Amount |
37821.79 |
Total Medical Medicare Payment Amount |
28582.94 |
Total Medical Medicare Standardized Payment Amount |
27039.72 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
212 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
203 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5421 |