National Provider Identifier [NPI]: |
1588952311 |
Last Name Of The Provider |
OLACIO |
First Name Of The Provider |
MARIZELI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.P.M |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9838 NE 2ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIAMI SHORES |
Zip Code Of The Provider |
331382313 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1938 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
266671.13 |
Total Medicare Allowed Amount |
127842.97 |
Total Medicare Payment Amount |
94986.9 |
Total Medicare Standardized Payment Amount |
88201.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
128 |
Total Drug Medicare AllowedAmount |
43.47 |
Total Drug Medicare PaymentAmount |
34.09 |
Total Drug Medicare Standardized Payment Amount |
34.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
1923 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
266543.13 |
Total Medical Medicare Allowed Amount |
127799.5 |
Total Medical Medicare Payment Amount |
94952.81 |
Total Medical Medicare Standardized Payment Amount |
88167.57 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
84 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
177 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0668 |