National Provider Identifier [NPI]: |
1598738908 |
Last Name Of The Provider |
GONZALEZ-CANO |
First Name Of The Provider |
JORGE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 LAKELAND HILLS BLVD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKELAND |
Zip Code Of The Provider |
338053019 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
7437 |
Number Of Medicare Beneficiaries |
3389 |
Total Submitted Charge Amount |
603228 |
Total Medicare Allowed Amount |
338220.08 |
Total Medicare Payment Amount |
289338.67 |
Total Medicare Standardized Payment Amount |
293653.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
2979 |
Number Of Medicare Beneficiaries With Drug Services |
2761 |
Total Drug Submitted ChargeAmount |
164562 |
Total Drug Medicare AllowedAmount |
104277.31 |
Total Drug Medicare PaymentAmount |
100628.69 |
Total Drug Medicare Standardized Payment Amount |
100628.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
4458 |
Number Of Medicare Beneficiaries With Medical Services |
3386 |
Total Medical Submitted Charge Amount |
438666 |
Total Medical Medicare Allowed Amount |
233942.77 |
Total Medical Medicare Payment Amount |
188709.98 |
Total Medical Medicare Standardized Payment Amount |
193025.19 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
1338 |
Number Of Beneficiaries Age 75 to 84 |
1364 |
Number Of Beneficiaries Age Greater 84 |
581 |
Number Of Female Beneficiaries |
1857 |
Number Of Male Beneficiaries |
1532 |
Number Of Non Hispanic White Beneficiaries |
3163 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
92 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
3250 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0763 |