National Provider Identifier [NPI]: |
1215969084 |
Last Name Of The Provider |
NAVARRO |
First Name Of The Provider |
CECIL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
CARR 111 RM 1417 |
Street Address 2 Of The Provider |
HOSPITAL BUEN SAMARITENO |
City Of The Provider |
AGUADILLA |
Zip Code Of The Provider |
00605 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
185 |
Number Of Medicare Beneficiaries |
73 |
Total Submitted Charge Amount |
20838.62 |
Total Medicare Allowed Amount |
20179.13 |
Total Medicare Payment Amount |
15307.5 |
Total Medicare Standardized Payment Amount |
17799.29 |
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 |
10 |
Number Of Medical Services |
185 |
Number Of Medicare Beneficiaries With Medical Services |
73 |
Total Medical Submitted Charge Amount |
20838.62 |
Total Medical Medicare Allowed Amount |
20179.13 |
Total Medical Medicare Payment Amount |
15307.5 |
Total Medical Medicare Standardized Payment Amount |
17799.29 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
16 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
33 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
74 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
4.1531 |