National Provider Identifier [NPI]: |
1417913716 |
Last Name Of The Provider |
PIEDAD |
First Name Of The Provider |
OSCAR |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
461 W OAK STREET |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
KISSIMMEE |
Zip Code Of The Provider |
34741 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1000 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
51644.14 |
Total Medicare Allowed Amount |
44157.62 |
Total Medicare Payment Amount |
30916.48 |
Total Medicare Standardized Payment Amount |
31903.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
299 |
Number Of Medicare Beneficiaries With Drug Services |
62 |
Total Drug Submitted ChargeAmount |
2810 |
Total Drug Medicare AllowedAmount |
1366 |
Total Drug Medicare PaymentAmount |
1172.85 |
Total Drug Medicare Standardized Payment Amount |
1172.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
701 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
48834.14 |
Total Medical Medicare Allowed Amount |
42791.62 |
Total Medical Medicare Payment Amount |
29743.63 |
Total Medical Medicare Standardized Payment Amount |
30730.22 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
148 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
66 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3819 |