| National Provider Identifier [NPI]: | 1922058718 |
| Last Name Of The Provider | HENRIQUEZ |
| First Name Of The Provider | JAIME |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 W HUNTINGTON DR |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | ARCADIA |
| Zip Code Of The Provider | 910073462 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 6119 |
| Number Of Medicare Beneficiaries | 1502 |
| Total Submitted Charge Amount | 1556334.88 |
| Total Medicare Allowed Amount | 541423.44 |
| Total Medicare Payment Amount | 417887.78 |
| Total Medicare Standardized Payment Amount | 386059.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1989 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 61568.08 |
| Total Drug Medicare AllowedAmount | 23387.85 |
| Total Drug Medicare PaymentAmount | 18335.97 |
| Total Drug Medicare Standardized Payment Amount | 18335.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 4130 |
| Number Of Medicare Beneficiaries With Medical Services | 1501 |
| Total Medical Submitted Charge Amount | 1494766.8 |
| Total Medical Medicare Allowed Amount | 518035.59 |
| Total Medical Medicare Payment Amount | 399551.81 |
| Total Medical Medicare Standardized Payment Amount | 367723.08 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 458 |
| Number Of Beneficiaries Age 75 to 84 | 499 |
| Number Of Beneficiaries Age Greater 84 | 408 |
| Number Of Female Beneficiaries | 844 |
| Number Of Male Beneficiaries | 658 |
| Number Of Non Hispanic White Beneficiaries | 781 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 239 |
| Number Of Hispanic Beneficiaries | 401 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 862 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 640 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.2494 |