National Provider Identifier [NPI]: |
1316068612 |
Last Name Of The Provider |
PESTANA |
First Name Of The Provider |
ROCIO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5975 SUNSET DR |
Street Address 2 Of The Provider |
SUITE 804 |
City Of The Provider |
SOUTH MIAMI |
Zip Code Of The Provider |
331435166 |
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 |
12 |
Number Of Services |
466 |
Number Of Medicare Beneficiaries |
149 |
Total Submitted Charge Amount |
59446 |
Total Medicare Allowed Amount |
29377.26 |
Total Medicare Payment Amount |
21480.57 |
Total Medicare Standardized Payment Amount |
20116.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
56 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
2719 |
Total Drug Medicare AllowedAmount |
1460.75 |
Total Drug Medicare PaymentAmount |
1428.19 |
Total Drug Medicare Standardized Payment Amount |
1428.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
410 |
Number Of Medicare Beneficiaries With Medical Services |
149 |
Total Medical Submitted Charge Amount |
56727 |
Total Medical Medicare Allowed Amount |
27916.51 |
Total Medical Medicare Payment Amount |
20052.38 |
Total Medical Medicare Standardized Payment Amount |
18688.43 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
103 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
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 |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.93 |