National Provider Identifier [NPI]: |
1578519344 |
Last Name Of The Provider |
NADAL |
First Name Of The Provider |
HERMAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6710 TAFT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLLYWOOD |
Zip Code Of The Provider |
33024 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
588 |
Number Of Medicare Beneficiaries |
139 |
Total Submitted Charge Amount |
56185 |
Total Medicare Allowed Amount |
56094.11 |
Total Medicare Payment Amount |
42544.51 |
Total Medicare Standardized Payment Amount |
47876.98 |
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 |
4 |
Number Of Medical Services |
588 |
Number Of Medicare Beneficiaries With Medical Services |
139 |
Total Medical Submitted Charge Amount |
56185 |
Total Medical Medicare Allowed Amount |
56094.11 |
Total Medical Medicare Payment Amount |
42544.51 |
Total Medical Medicare Standardized Payment Amount |
47876.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
107 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2847 |