National Provider Identifier [NPI]: |
1821009390 |
Last Name Of The Provider |
DELACRUZ |
First Name Of The Provider |
RICHARD |
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 |
3625 UNIVERSITY BLVD S |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322164207 |
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 |
34 |
Number Of Services |
3149 |
Number Of Medicare Beneficiaries |
1816 |
Total Submitted Charge Amount |
1432397 |
Total Medicare Allowed Amount |
263898.48 |
Total Medicare Payment Amount |
204871.33 |
Total Medicare Standardized Payment Amount |
203493.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
3149 |
Number Of Medicare Beneficiaries With Medical Services |
1816 |
Total Medical Submitted Charge Amount |
1432397 |
Total Medical Medicare Allowed Amount |
263898.48 |
Total Medical Medicare Payment Amount |
204871.33 |
Total Medical Medicare Standardized Payment Amount |
203493.81 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
490 |
Number Of Beneficiaries Age 65 to 74 |
477 |
Number Of Beneficiaries Age 75 to 84 |
460 |
Number Of Beneficiaries Age Greater 84 |
389 |
Number Of Female Beneficiaries |
1119 |
Number Of Male Beneficiaries |
697 |
Number Of Non Hispanic White Beneficiaries |
1272 |
Number Of Black or African American Beneficiaries |
407 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
109 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
927 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
889 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4106 |