National Provider Identifier [NPI]: |
1427120500 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
HECTOR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MPAS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2804 SAINT JOHNS BLUFF RD S STE 109 |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322463777 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2322 |
Number Of Medicare Beneficiaries |
399 |
Total Submitted Charge Amount |
180793.32 |
Total Medicare Allowed Amount |
113117.35 |
Total Medicare Payment Amount |
78552.67 |
Total Medicare Standardized Payment Amount |
97643.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
334.8 |
Total Drug Medicare AllowedAmount |
334.8 |
Total Drug Medicare PaymentAmount |
262.4 |
Total Drug Medicare Standardized Payment Amount |
262.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2291 |
Number Of Medicare Beneficiaries With Medical Services |
399 |
Total Medical Submitted Charge Amount |
180458.52 |
Total Medical Medicare Allowed Amount |
112782.55 |
Total Medical Medicare Payment Amount |
78290.27 |
Total Medical Medicare Standardized Payment Amount |
97381.38 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
229 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
375 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9467 |