| National Provider Identifier [NPI]: | 1932192325 |
| Last Name Of The Provider | HERNANDEZ |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 2ND STREET EAST |
| Street Address 2 Of The Provider | SUITE 3B |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342081029 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 3832 |
| Number Of Medicare Beneficiaries | 1114 |
| Total Submitted Charge Amount | 732214 |
| Total Medicare Allowed Amount | 371057.89 |
| Total Medicare Payment Amount | 272560.14 |
| Total Medicare Standardized Payment Amount | 271653.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 3832 |
| Number Of Medicare Beneficiaries With Medical Services | 1114 |
| Total Medical Submitted Charge Amount | 732214 |
| Total Medical Medicare Allowed Amount | 371057.89 |
| Total Medical Medicare Payment Amount | 272560.14 |
| Total Medical Medicare Standardized Payment Amount | 271653.87 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 350 |
| Number Of Beneficiaries Age Greater 84 | 285 |
| Number Of Female Beneficiaries | 604 |
| Number Of Male Beneficiaries | 510 |
| Number Of Non Hispanic White Beneficiaries | 981 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 819 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 295 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7394 |