| National Provider Identifier [NPI]: | 1033195896 |
| Last Name Of The Provider | SEQUEIRA |
| First Name Of The Provider | MARIO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1286 S FLORIDA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKLEDGE |
| Zip Code Of The Provider | 32955 |
| 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 | 97 |
| Number Of Services | 8029 |
| Number Of Medicare Beneficiaries | 1525 |
| Total Submitted Charge Amount | 1389653.4 |
| Total Medicare Allowed Amount | 847122.15 |
| Total Medicare Payment Amount | 641972.35 |
| Total Medicare Standardized Payment Amount | 642499.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 110 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 21773.4 |
| Total Drug Medicare AllowedAmount | 19674.86 |
| Total Drug Medicare PaymentAmount | 14992.25 |
| Total Drug Medicare Standardized Payment Amount | 14992.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 7919 |
| Number Of Medicare Beneficiaries With Medical Services | 1525 |
| Total Medical Submitted Charge Amount | 1367880 |
| Total Medical Medicare Allowed Amount | 827447.29 |
| Total Medical Medicare Payment Amount | 626980.1 |
| Total Medical Medicare Standardized Payment Amount | 627507.17 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 662 |
| Number Of Beneficiaries Age 75 to 84 | 585 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 697 |
| Number Of Male Beneficiaries | 828 |
| Number Of Non Hispanic White Beneficiaries | 1470 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1497 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0706 |