National Provider Identifier [NPI]: |
1013240035 |
Last Name Of The Provider |
MERCADO |
First Name Of The Provider |
RONNIEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2700 HEALING WAY |
Street Address 2 Of The Provider |
SUITE 320 |
City Of The Provider |
WESLEY CHAPEL |
Zip Code Of The Provider |
335435453 |
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 |
25 |
Number Of Services |
1971 |
Number Of Medicare Beneficiaries |
707 |
Total Submitted Charge Amount |
455749 |
Total Medicare Allowed Amount |
231077.04 |
Total Medicare Payment Amount |
178552.54 |
Total Medicare Standardized Payment Amount |
178216.64 |
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 |
25 |
Number Of Medical Services |
1971 |
Number Of Medicare Beneficiaries With Medical Services |
707 |
Total Medical Submitted Charge Amount |
455749 |
Total Medical Medicare Allowed Amount |
231077.04 |
Total Medical Medicare Payment Amount |
178552.54 |
Total Medical Medicare Standardized Payment Amount |
178216.64 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
242 |
Number Of Beneficiaries Age Greater 84 |
165 |
Number Of Female Beneficiaries |
389 |
Number Of Male Beneficiaries |
318 |
Number Of Non Hispanic White Beneficiaries |
590 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
483 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
224 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.0566 |