| National Provider Identifier [NPI]: | 1093973661 |
| Last Name Of The Provider | MASSARE-RODRIGUEZ |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 709 HOLLYBROOK DR |
| Street Address 2 Of The Provider | SUITE 2301 |
| City Of The Provider | LONGVIEW |
| Zip Code Of The Provider | 756052411 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 8370 |
| Number Of Medicare Beneficiaries | 1322 |
| Total Submitted Charge Amount | 1915203.5 |
| Total Medicare Allowed Amount | 696372.57 |
| Total Medicare Payment Amount | 532289.56 |
| Total Medicare Standardized Payment Amount | 557955.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 231 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 22470 |
| Total Drug Medicare AllowedAmount | 11876.49 |
| Total Drug Medicare PaymentAmount | 9311.11 |
| Total Drug Medicare Standardized Payment Amount | 9311.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 148 |
| Number Of Medical Services | 8139 |
| Number Of Medicare Beneficiaries With Medical Services | 1322 |
| Total Medical Submitted Charge Amount | 1892733.5 |
| Total Medical Medicare Allowed Amount | 684496.08 |
| Total Medical Medicare Payment Amount | 522978.45 |
| Total Medical Medicare Standardized Payment Amount | 548644.13 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 437 |
| Number Of Beneficiaries Age 75 to 84 | 521 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 693 |
| Number Of Male Beneficiaries | 629 |
| Number Of Non Hispanic White Beneficiaries | 1172 |
| Number Of Black or African American Beneficiaries | 127 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1084 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 41 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7826 |