| National Provider Identifier [NPI]: | 1801068937 |
| Last Name Of The Provider | CABALLERO |
| First Name Of The Provider | JUAN-CARLOS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 BLACKWELL PARK LN |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | WARRENTON |
| Zip Code Of The Provider | 201862685 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 6692 |
| Number Of Medicare Beneficiaries | 1156 |
| Total Submitted Charge Amount | 1048214.19 |
| Total Medicare Allowed Amount | 368748.15 |
| Total Medicare Payment Amount | 262610.79 |
| Total Medicare Standardized Payment Amount | 266384.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 13592.04 |
| Total Drug Medicare AllowedAmount | 10860.43 |
| Total Drug Medicare PaymentAmount | 8486.94 |
| Total Drug Medicare Standardized Payment Amount | 8486.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 6634 |
| Number Of Medicare Beneficiaries With Medical Services | 1156 |
| Total Medical Submitted Charge Amount | 1034622.15 |
| Total Medical Medicare Allowed Amount | 357887.72 |
| Total Medical Medicare Payment Amount | 254123.85 |
| Total Medical Medicare Standardized Payment Amount | 257897.49 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 657 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 612 |
| Number Of Male Beneficiaries | 544 |
| Number Of Non Hispanic White Beneficiaries | 1108 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1131 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8435 |