National Provider Identifier [NPI]: |
1932100088 |
Last Name Of The Provider |
HERNANDEZ |
First Name Of The Provider |
RENE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1845 CARR 2 |
Street Address 2 Of The Provider |
SUITE 809 |
City Of The Provider |
BAYAMON |
Zip Code Of The Provider |
009597206 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
273 |
Number Of Medicare Beneficiaries |
79 |
Total Submitted Charge Amount |
18816.35 |
Total Medicare Allowed Amount |
16088.13 |
Total Medicare Payment Amount |
11559.19 |
Total Medicare Standardized Payment Amount |
14121.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
531.85 |
Total Drug Medicare AllowedAmount |
155.22 |
Total Drug Medicare PaymentAmount |
113.08 |
Total Drug Medicare Standardized Payment Amount |
113.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
226 |
Number Of Medicare Beneficiaries With Medical Services |
79 |
Total Medical Submitted Charge Amount |
18284.5 |
Total Medical Medicare Allowed Amount |
15932.91 |
Total Medical Medicare Payment Amount |
11446.11 |
Total Medical Medicare Standardized Payment Amount |
14008.01 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
15 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
23 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0684 |