| National Provider Identifier [NPI]: | 1184697195 |
| Last Name Of The Provider | MAS |
| First Name Of The Provider | ILDEFONSO |
| 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 | 3181 CORAL WAY |
| Street Address 2 Of The Provider | 5TH FLOOR |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 33145 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 850 |
| Number Of Medicare Beneficiaries | 192 |
| Total Submitted Charge Amount | 233285 |
| Total Medicare Allowed Amount | 76198.24 |
| Total Medicare Payment Amount | 59790.89 |
| Total Medicare Standardized Payment Amount | 57363.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 680 |
| Total Drug Medicare AllowedAmount | 89.37 |
| Total Drug Medicare PaymentAmount | 86.57 |
| Total Drug Medicare Standardized Payment Amount | 86.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 833 |
| Number Of Medicare Beneficiaries With Medical Services | 192 |
| Total Medical Submitted Charge Amount | 232605 |
| Total Medical Medicare Allowed Amount | 76108.87 |
| Total Medical Medicare Payment Amount | 59704.32 |
| Total Medical Medicare Standardized Payment Amount | 57277.24 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 167 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 81 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 111 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.479 |