| National Provider Identifier [NPI]: | 1740338714 |
| Last Name Of The Provider | HERNANDEZ |
| First Name Of The Provider | ROMANA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 E BOULDER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809095533 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 794 |
| Number Of Medicare Beneficiaries | 495 |
| Total Submitted Charge Amount | 339091 |
| Total Medicare Allowed Amount | 90467.86 |
| Total Medicare Payment Amount | 70313.55 |
| Total Medicare Standardized Payment Amount | 70455.66 |
| 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 | 25 |
| Number Of Medical Services | 794 |
| Number Of Medicare Beneficiaries With Medical Services | 495 |
| Total Medical Submitted Charge Amount | 339091 |
| Total Medical Medicare Allowed Amount | 90467.86 |
| Total Medical Medicare Payment Amount | 70313.55 |
| Total Medical Medicare Standardized Payment Amount | 70455.66 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 177 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 259 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 364 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 323 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7161 |