National Provider Identifier [NPI]: |
1801878889 |
Last Name Of The Provider |
FERNANDEZ |
First Name Of The Provider |
JUAN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13303 SW 42ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331753269 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2833 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
379035 |
Total Medicare Allowed Amount |
228943.78 |
Total Medicare Payment Amount |
178629.31 |
Total Medicare Standardized Payment Amount |
167266.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
92 |
Number Of Medicare Beneficiaries With Drug Services |
81 |
Total Drug Submitted ChargeAmount |
8840 |
Total Drug Medicare AllowedAmount |
1313.6 |
Total Drug Medicare PaymentAmount |
1278.44 |
Total Drug Medicare Standardized Payment Amount |
1278.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2741 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
370195 |
Total Medical Medicare Allowed Amount |
227630.18 |
Total Medical Medicare Payment Amount |
177350.87 |
Total Medical Medicare Standardized Payment Amount |
165988.45 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
226 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
28 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6987 |