National Provider Identifier [NPI]: |
1649353293 |
Last Name Of The Provider |
TORRES-RIVERA |
First Name Of The Provider |
EDWIN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
735 AVE PONCE DE LEON STE 604 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN JUAN |
Zip Code Of The Provider |
009175028 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
665 |
Number Of Medicare Beneficiaries |
206 |
Total Submitted Charge Amount |
249514.41 |
Total Medicare Allowed Amount |
120010.47 |
Total Medicare Payment Amount |
93122.86 |
Total Medicare Standardized Payment Amount |
114314.03 |
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 |
58 |
Number Of Medical Services |
665 |
Number Of Medicare Beneficiaries With Medical Services |
206 |
Total Medical Submitted Charge Amount |
249514.41 |
Total Medical Medicare Allowed Amount |
120010.47 |
Total Medical Medicare Payment Amount |
93122.86 |
Total Medical Medicare Standardized Payment Amount |
114314.03 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
110 |
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 |
9 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
5.4074 |