National Provider Identifier [NPI]: |
1528005048 |
Last Name Of The Provider |
ERQUIAGA |
First Name Of The Provider |
EUGENIO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
512 NOKOMIS AVE S |
Street Address 2 Of The Provider |
|
City Of The Provider |
VENICE |
Zip Code Of The Provider |
342852817 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
256 |
Number Of Services |
96139.5 |
Number Of Medicare Beneficiaries |
7070 |
Total Submitted Charge Amount |
1563767.55 |
Total Medicare Allowed Amount |
1318820 |
Total Medicare Payment Amount |
1048386.81 |
Total Medicare Standardized Payment Amount |
1078126.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
82580.5 |
Number Of Medicare Beneficiaries With Drug Services |
935 |
Total Drug Submitted ChargeAmount |
54961.6 |
Total Drug Medicare AllowedAmount |
21192.04 |
Total Drug Medicare PaymentAmount |
16503.76 |
Total Drug Medicare Standardized Payment Amount |
16503.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
244 |
Number Of Medical Services |
13559 |
Number Of Medicare Beneficiaries With Medical Services |
7069 |
Total Medical Submitted Charge Amount |
1508805.95 |
Total Medical Medicare Allowed Amount |
1297627.96 |
Total Medical Medicare Payment Amount |
1031883.05 |
Total Medical Medicare Standardized Payment Amount |
1061622.46 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
323 |
Number Of Beneficiaries Age 65 to 74 |
2870 |
Number Of Beneficiaries Age 75 to 84 |
2550 |
Number Of Beneficiaries Age Greater 84 |
1327 |
Number Of Female Beneficiaries |
4415 |
Number Of Male Beneficiaries |
2655 |
Number Of Non Hispanic White Beneficiaries |
6866 |
Number Of Black or African American Beneficiaries |
35 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
77 |
Number Of Beneficiaries With Medicare Only Entitlement |
6651 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
419 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2994 |