| National Provider Identifier [NPI]: | 1083925424 |
| Last Name Of The Provider | JIMENEZ |
| First Name Of The Provider | HAROLD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4700 ALLIANCE BLVD |
| Street Address 2 Of The Provider | BAYLOR REGIONAL MEDICAL CENTER OF PLANO/EMERGENCY DEPT. |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750935323 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 916 |
| Number Of Medicare Beneficiaries | 716 |
| Total Submitted Charge Amount | 1029689 |
| Total Medicare Allowed Amount | 125066 |
| Total Medicare Payment Amount | 95298.73 |
| Total Medicare Standardized Payment Amount | 98280.82 |
| 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 | 33 |
| Number Of Medical Services | 916 |
| Number Of Medicare Beneficiaries With Medical Services | 716 |
| Total Medical Submitted Charge Amount | 1029689 |
| Total Medical Medicare Allowed Amount | 125066 |
| Total Medical Medicare Payment Amount | 95298.73 |
| Total Medical Medicare Standardized Payment Amount | 98280.82 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 403 |
| Number Of Male Beneficiaries | 313 |
| Number Of Non Hispanic White Beneficiaries | 603 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 614 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9823 |