National Provider Identifier [NPI]: |
1700807526 |
Last Name Of The Provider |
ZEBALLOS |
First Name Of The Provider |
HILBERT |
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 |
20 E MELBOURNE AVE STE 104 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
329015970 |
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 |
2337 |
Number Of Medicare Beneficiaries |
238 |
Total Submitted Charge Amount |
604150 |
Total Medicare Allowed Amount |
233146.34 |
Total Medicare Payment Amount |
182759.56 |
Total Medicare Standardized Payment Amount |
181000.31 |
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 |
2337 |
Number Of Medicare Beneficiaries With Medical Services |
238 |
Total Medical Submitted Charge Amount |
604150 |
Total Medical Medicare Allowed Amount |
233146.34 |
Total Medical Medicare Payment Amount |
182759.56 |
Total Medical Medicare Standardized Payment Amount |
181000.31 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
209 |
Number Of Black or African American Beneficiaries |
15 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
42 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
70 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
71 |
Percent Of With Depression |
63 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
3.544 |