National Provider Identifier [NPI]: |
1164495297 |
Last Name Of The Provider |
NAZARIO |
First Name Of The Provider |
BRUNILDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1933 W LUMSDEN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRANDON |
Zip Code Of The Provider |
335118819 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
552 |
Number Of Medicare Beneficiaries |
56 |
Total Submitted Charge Amount |
14465 |
Total Medicare Allowed Amount |
9452.33 |
Total Medicare Payment Amount |
6459.9 |
Total Medicare Standardized Payment Amount |
6524.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
261 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1055 |
Total Drug Medicare AllowedAmount |
653.23 |
Total Drug Medicare PaymentAmount |
595.97 |
Total Drug Medicare Standardized Payment Amount |
595.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
291 |
Number Of Medicare Beneficiaries With Medical Services |
56 |
Total Medical Submitted Charge Amount |
13410 |
Total Medical Medicare Allowed Amount |
8799.1 |
Total Medical Medicare Payment Amount |
5863.93 |
Total Medical Medicare Standardized Payment Amount |
5928.74 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
17 |
Number Of Non Hispanic White Beneficiaries |
28 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
44 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
|
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5181 |