National Provider Identifier [NPI]: |
1649299215 |
Last Name Of The Provider |
MARTINEZ |
First Name Of The Provider |
HUMBERTO |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1611 NW 12TH AVE |
Street Address 2 Of The Provider |
BOX 016960 (M851) |
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331361005 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
3046 |
Number Of Medicare Beneficiaries |
1172 |
Total Submitted Charge Amount |
203501 |
Total Medicare Allowed Amount |
43323 |
Total Medicare Payment Amount |
32426.2 |
Total Medicare Standardized Payment Amount |
30689.24 |
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 |
11 |
Number Of Medical Services |
3046 |
Number Of Medicare Beneficiaries With Medical Services |
1172 |
Total Medical Submitted Charge Amount |
203501 |
Total Medical Medicare Allowed Amount |
43323 |
Total Medical Medicare Payment Amount |
32426.2 |
Total Medical Medicare Standardized Payment Amount |
30689.24 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
485 |
Number Of Beneficiaries Age 65 to 74 |
436 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
503 |
Number Of Male Beneficiaries |
669 |
Number Of Non Hispanic White Beneficiaries |
295 |
Number Of Black or African American Beneficiaries |
356 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
493 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
805 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.5846 |