National Provider Identifier [NPI]: |
1649212762 |
Last Name Of The Provider |
HERNANDEZ |
First Name Of The Provider |
ALEXANDER |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
PT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4110 MANATEE AVE W |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRADENTON |
Zip Code Of The Provider |
342051719 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
8232 |
Number Of Medicare Beneficiaries |
262 |
Total Submitted Charge Amount |
498076 |
Total Medicare Allowed Amount |
213621.03 |
Total Medicare Payment Amount |
163171.18 |
Total Medicare Standardized Payment Amount |
123071.6 |
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 |
8232 |
Number Of Medicare Beneficiaries With Medical Services |
262 |
Total Medical Submitted Charge Amount |
498076 |
Total Medical Medicare Allowed Amount |
213621.03 |
Total Medical Medicare Payment Amount |
163171.18 |
Total Medical Medicare Standardized Payment Amount |
123071.6 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
248 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2896 |