| National Provider Identifier [NPI]: | 1295734101 |
| Last Name Of The Provider | DEJESUS |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 685 PALM SPRINGS DR |
| Street Address 2 Of The Provider | STE 2A |
| City Of The Provider | ALTAMONTE SPRINGS |
| Zip Code Of The Provider | 327017853 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 7258 |
| Number Of Medicare Beneficiaries | 360 |
| Total Submitted Charge Amount | 183208 |
| Total Medicare Allowed Amount | 116747.57 |
| Total Medicare Payment Amount | 81891.88 |
| Total Medicare Standardized Payment Amount | 82922.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 6207 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 38561 |
| Total Drug Medicare AllowedAmount | 16252.87 |
| Total Drug Medicare PaymentAmount | 14425.33 |
| Total Drug Medicare Standardized Payment Amount | 14425.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1051 |
| Number Of Medicare Beneficiaries With Medical Services | 360 |
| Total Medical Submitted Charge Amount | 144647 |
| Total Medical Medicare Allowed Amount | 100494.7 |
| Total Medical Medicare Payment Amount | 67466.55 |
| Total Medical Medicare Standardized Payment Amount | 68497.18 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 277 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 190 |
| Number Of Black or African American Beneficiaries | 99 |
| 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 | 126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 234 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.619 |