| National Provider Identifier [NPI]: | 1992787048 |
| Last Name Of The Provider | MARRERO |
| First Name Of The Provider | CARMEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 488 CARR 845 |
| Street Address 2 Of The Provider | URB PURPLE TREE |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 009264403 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 1870 |
| Number Of Medicare Beneficiaries | 74 |
| Total Submitted Charge Amount | 72169.8 |
| Total Medicare Allowed Amount | 68340.96 |
| Total Medicare Payment Amount | 51303.72 |
| Total Medicare Standardized Payment Amount | 61121.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 25 |
| Number Of Drug Services | 779 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 8241.6 |
| Total Drug Medicare AllowedAmount | 6151.98 |
| Total Drug Medicare PaymentAmount | 4773.9 |
| Total Drug Medicare Standardized Payment Amount | 4773.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1091 |
| Number Of Medicare Beneficiaries With Medical Services | 74 |
| Total Medical Submitted Charge Amount | 63928.2 |
| Total Medical Medicare Allowed Amount | 62188.98 |
| Total Medical Medicare Payment Amount | 46529.82 |
| Total Medical Medicare Standardized Payment Amount | 56348.04 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 20 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 0 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 74 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 28 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1394 |