National Provider Identifier [NPI]: |
1285664920 |
Last Name Of The Provider |
MALDONADO |
First Name Of The Provider |
RICARDO |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 PEPPERELL PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
OPELIKA |
Zip Code Of The Provider |
368015452 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1883 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
202133.84 |
Total Medicare Allowed Amount |
147937.13 |
Total Medicare Payment Amount |
114900.72 |
Total Medicare Standardized Payment Amount |
124557.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1598 |
Total Drug Medicare AllowedAmount |
245.52 |
Total Drug Medicare PaymentAmount |
240.59 |
Total Drug Medicare Standardized Payment Amount |
240.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
1866 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
200535.84 |
Total Medical Medicare Allowed Amount |
147691.61 |
Total Medical Medicare Payment Amount |
114660.13 |
Total Medical Medicare Standardized Payment Amount |
124316.55 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
278 |
Number Of Black or African American Beneficiaries |
|
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 |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.5295 |