National Provider Identifier [NPI]: |
1225101058 |
Last Name Of The Provider |
ABANDO |
First Name Of The Provider |
JOSE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 N CLYDE MORRIS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTONA BEACH |
Zip Code Of The Provider |
321142709 |
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 |
15 |
Number Of Services |
1150 |
Number Of Medicare Beneficiaries |
379 |
Total Submitted Charge Amount |
140775 |
Total Medicare Allowed Amount |
89899.8 |
Total Medicare Payment Amount |
69076.33 |
Total Medicare Standardized Payment Amount |
68661.11 |
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 |
15 |
Number Of Medical Services |
1150 |
Number Of Medicare Beneficiaries With Medical Services |
379 |
Total Medical Submitted Charge Amount |
140775 |
Total Medical Medicare Allowed Amount |
89899.8 |
Total Medical Medicare Payment Amount |
69076.33 |
Total Medical Medicare Standardized Payment Amount |
68661.11 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
331 |
Number Of Black or African American Beneficiaries |
31 |
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 |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.1902 |