National Provider Identifier [NPI]: |
1265633358 |
Last Name Of The Provider |
DIMAS |
First Name Of The Provider |
KATYA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 NW 12TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331361003 |
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 |
1087 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
400010 |
Total Medicare Allowed Amount |
204023.23 |
Total Medicare Payment Amount |
159420.36 |
Total Medicare Standardized Payment Amount |
151584.47 |
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 |
1087 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
400010 |
Total Medical Medicare Allowed Amount |
204023.23 |
Total Medical Medicare Payment Amount |
159420.36 |
Total Medical Medicare Standardized Payment Amount |
151584.47 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
156 |
Number Of Beneficiaries Age Greater 84 |
210 |
Number Of Female Beneficiaries |
240 |
Number Of Male Beneficiaries |
236 |
Number Of Non Hispanic White Beneficiaries |
440 |
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 |
420 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
47 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
74 |
Percent Of With Chronic Kidney Disease |
72 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.0216 |