| National Provider Identifier [NPI]: | 1114034626 |
| Last Name Of The Provider | RIVERA |
| First Name Of The Provider | FERNANDO |
| 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 | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 1528 |
| Number Of Medicare Beneficiaries | 924 |
| Total Submitted Charge Amount | 79777.51 |
| Total Medicare Allowed Amount | 66953.9 |
| Total Medicare Payment Amount | 48791.09 |
| Total Medicare Standardized Payment Amount | 52533.09 |
| 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 | 11 |
| Number Of Medical Services | 1528 |
| Number Of Medicare Beneficiaries With Medical Services | 924 |
| Total Medical Submitted Charge Amount | 79777.51 |
| Total Medical Medicare Allowed Amount | 66953.9 |
| Total Medical Medicare Payment Amount | 48791.09 |
| Total Medical Medicare Standardized Payment Amount | 52533.09 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 369 |
| Number Of Beneficiaries Age Greater 84 | 263 |
| Number Of Female Beneficiaries | 413 |
| Number Of Male Beneficiaries | 511 |
| Number Of Non Hispanic White Beneficiaries | 853 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 889 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 71 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6125 |