National Provider Identifier [NPI]: |
1003814047 |
Last Name Of The Provider |
RIVERA |
First Name Of The Provider |
GILBERTO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
TORRE AUXILIO MUTUO PONCE DE LEON AVE 735 |
Street Address 2 Of The Provider |
SUITE 516 |
City Of The Provider |
SAN JUAN |
Zip Code Of The Provider |
00917 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1423 |
Number Of Medicare Beneficiaries |
353 |
Total Submitted Charge Amount |
81391.61 |
Total Medicare Allowed Amount |
80849.95 |
Total Medicare Payment Amount |
58278.16 |
Total Medicare Standardized Payment Amount |
72157.45 |
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 |
33 |
Number Of Medical Services |
1423 |
Number Of Medicare Beneficiaries With Medical Services |
353 |
Total Medical Submitted Charge Amount |
81391.61 |
Total Medical Medicare Allowed Amount |
80849.95 |
Total Medical Medicare Payment Amount |
58278.16 |
Total Medical Medicare Standardized Payment Amount |
72157.45 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
10 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.8484 |