| National Provider Identifier [NPI]: | 1265522635 |
| Last Name Of The Provider | OTERO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10000 BAY PINES BOULEVARD |
| Street Address 2 Of The Provider | BAY PINES V.A. HOSPITAL |
| City Of The Provider | BAY PINES |
| Zip Code Of The Provider | 33744 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 3316 |
| Number Of Medicare Beneficiaries | 514 |
| Total Submitted Charge Amount | 2221845 |
| Total Medicare Allowed Amount | 285918.34 |
| Total Medicare Payment Amount | 213013.82 |
| Total Medicare Standardized Payment Amount | 220446.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 243 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 5057 |
| Total Drug Medicare AllowedAmount | 688.83 |
| Total Drug Medicare PaymentAmount | 532.15 |
| Total Drug Medicare Standardized Payment Amount | 532.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 3073 |
| Number Of Medicare Beneficiaries With Medical Services | 514 |
| Total Medical Submitted Charge Amount | 2216788 |
| Total Medical Medicare Allowed Amount | 285229.51 |
| Total Medical Medicare Payment Amount | 212481.67 |
| Total Medical Medicare Standardized Payment Amount | 219914.73 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 371 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 235 |
| Number Of Non Hispanic White Beneficiaries | 308 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 103 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 339 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.739 |