| National Provider Identifier [NPI]: | 1992777460 |
| Last Name Of The Provider | MARINA |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1022 E. GRIFFIN PKWY STE 108 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MISSION |
| Zip Code Of The Provider | 78572 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 5921 |
| Number Of Medicare Beneficiaries | 918 |
| Total Submitted Charge Amount | 1572503.36 |
| Total Medicare Allowed Amount | 534951.65 |
| Total Medicare Payment Amount | 403937.08 |
| Total Medicare Standardized Payment Amount | 422248.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1386 |
| Number Of Medicare Beneficiaries With Drug Services | 507 |
| Total Drug Submitted ChargeAmount | 77390 |
| Total Drug Medicare AllowedAmount | 26396.24 |
| Total Drug Medicare PaymentAmount | 20461.56 |
| Total Drug Medicare Standardized Payment Amount | 20461.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 4535 |
| Number Of Medicare Beneficiaries With Medical Services | 918 |
| Total Medical Submitted Charge Amount | 1495113.36 |
| Total Medical Medicare Allowed Amount | 508555.41 |
| Total Medical Medicare Payment Amount | 383475.52 |
| Total Medical Medicare Standardized Payment Amount | 401786.78 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 349 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 581 |
| Number Of Male Beneficiaries | 337 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 481 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 557 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 361 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5329 |