National Provider Identifier [NPI]: |
1316942949 |
Last Name Of The Provider |
SOLORZANO |
First Name Of The Provider |
MARTIN |
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 |
3954 PREMIER NORTH DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336188795 |
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 |
60 |
Number Of Services |
4242 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
362630 |
Total Medicare Allowed Amount |
164887.07 |
Total Medicare Payment Amount |
123491.85 |
Total Medicare Standardized Payment Amount |
124162.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
321 |
Number Of Medicare Beneficiaries With Drug Services |
166 |
Total Drug Submitted ChargeAmount |
16054 |
Total Drug Medicare AllowedAmount |
7852.49 |
Total Drug Medicare PaymentAmount |
7653.13 |
Total Drug Medicare Standardized Payment Amount |
7653.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
3921 |
Number Of Medicare Beneficiaries With Medical Services |
260 |
Total Medical Submitted Charge Amount |
346576 |
Total Medical Medicare Allowed Amount |
157034.58 |
Total Medical Medicare Payment Amount |
115838.72 |
Total Medical Medicare Standardized Payment Amount |
116509.85 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
210 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1208 |