| National Provider Identifier [NPI]: | 1457318149 |
| Last Name Of The Provider | POMALES |
| First Name Of The Provider | SARI |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 AVE ROOSEVELT |
| Street Address 2 Of The Provider | CLINICA LAS AMERICAS SUITE 404 |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 00918 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 916 |
| Number Of Medicare Beneficiaries | 183 |
| Total Submitted Charge Amount | 51000.68 |
| Total Medicare Allowed Amount | 38342.01 |
| Total Medicare Payment Amount | 28521.38 |
| Total Medicare Standardized Payment Amount | 35585.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 219 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 897.16 |
| Total Drug Medicare AllowedAmount | 372.71 |
| Total Drug Medicare PaymentAmount | 286.49 |
| Total Drug Medicare Standardized Payment Amount | 286.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 697 |
| Number Of Medicare Beneficiaries With Medical Services | 183 |
| Total Medical Submitted Charge Amount | 50103.52 |
| Total Medical Medicare Allowed Amount | 37969.3 |
| Total Medical Medicare Payment Amount | 28234.89 |
| Total Medical Medicare Standardized Payment Amount | 35298.98 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | 0 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 183 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 73 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 36 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.193 |