National Provider Identifier [NPI]: |
1942218433 |
Last Name Of The Provider |
VINARDELL |
First Name Of The Provider |
SILVIO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
JACKSON SOUTH COMMUNITY HOSPITAL |
Street Address 2 Of The Provider |
9333 S.W. 152ND STREET |
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331571778 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pediatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
300 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
186623 |
Total Medicare Allowed Amount |
52561.89 |
Total Medicare Payment Amount |
37386.48 |
Total Medicare Standardized Payment Amount |
33432.24 |
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 |
11 |
Number Of Medical Services |
300 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
186623 |
Total Medical Medicare Allowed Amount |
52561.89 |
Total Medical Medicare Payment Amount |
37386.48 |
Total Medical Medicare Standardized Payment Amount |
33432.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
67 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
135 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
214 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
29 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.1105 |