National Provider Identifier [NPI]: |
1568755221 |
Last Name Of The Provider |
HERNANDEZ |
First Name Of The Provider |
MARLOW |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O., M.P.H. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 N UNIVERSITY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEMBROKE PINES |
Zip Code Of The Provider |
330246738 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
104 |
Number Of Services |
1052 |
Number Of Medicare Beneficiaries |
145 |
Total Submitted Charge Amount |
134738.55 |
Total Medicare Allowed Amount |
72223.95 |
Total Medicare Payment Amount |
51721.02 |
Total Medicare Standardized Payment Amount |
49262.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
96 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
3890.25 |
Total Drug Medicare AllowedAmount |
464.47 |
Total Drug Medicare PaymentAmount |
386.7 |
Total Drug Medicare Standardized Payment Amount |
386.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
956 |
Number Of Medicare Beneficiaries With Medical Services |
145 |
Total Medical Submitted Charge Amount |
130848.3 |
Total Medical Medicare Allowed Amount |
71759.48 |
Total Medical Medicare Payment Amount |
51334.32 |
Total Medical Medicare Standardized Payment Amount |
48875.5 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
46 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
55 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
3.037 |