| National Provider Identifier [NPI]: | 1063409225 |
| Last Name Of The Provider | TREJO-GUTIERREZ |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| 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 | 22 |
| Number Of Services | 3410 |
| Number Of Medicare Beneficiaries | 1715 |
| Total Submitted Charge Amount | 339902.2 |
| Total Medicare Allowed Amount | 272313.95 |
| Total Medicare Payment Amount | 198740.39 |
| Total Medicare Standardized Payment Amount | 212450.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1111 |
| Number Of Medicare Beneficiaries With Drug Services | 283 |
| Total Drug Submitted ChargeAmount | 72616.73 |
| Total Drug Medicare AllowedAmount | 55236.62 |
| Total Drug Medicare PaymentAmount | 41853.62 |
| Total Drug Medicare Standardized Payment Amount | 41853.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 2299 |
| Number Of Medicare Beneficiaries With Medical Services | 1680 |
| Total Medical Submitted Charge Amount | 267285.47 |
| Total Medical Medicare Allowed Amount | 217077.33 |
| Total Medical Medicare Payment Amount | 156886.77 |
| Total Medical Medicare Standardized Payment Amount | 170596.7 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 659 |
| Number Of Beneficiaries Age 75 to 84 | 646 |
| Number Of Beneficiaries Age Greater 84 | 290 |
| Number Of Female Beneficiaries | 702 |
| Number Of Male Beneficiaries | 1013 |
| Number Of Non Hispanic White Beneficiaries | 1504 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.602 |