| National Provider Identifier [NPI]: | 1588839765 |
| Last Name Of The Provider | RIVERA |
| First Name Of The Provider | ABIMAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD RPH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4180 US HIGHWAY 27 S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEBRING |
| Zip Code Of The Provider | 338705515 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 5959 |
| Number Of Medicare Beneficiaries | 1121 |
| Total Submitted Charge Amount | 1078175 |
| Total Medicare Allowed Amount | 563967.68 |
| Total Medicare Payment Amount | 421319.42 |
| Total Medicare Standardized Payment Amount | 408010.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 6840 |
| Total Drug Medicare AllowedAmount | 5769.36 |
| Total Drug Medicare PaymentAmount | 4517.58 |
| Total Drug Medicare Standardized Payment Amount | 4517.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 5902 |
| Number Of Medicare Beneficiaries With Medical Services | 1121 |
| Total Medical Submitted Charge Amount | 1071335 |
| Total Medical Medicare Allowed Amount | 558198.32 |
| Total Medical Medicare Payment Amount | 416801.84 |
| Total Medical Medicare Standardized Payment Amount | 403492.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 422 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 611 |
| Number Of Non Hispanic White Beneficiaries | 1062 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1001 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1602 |