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PROVIDER PROFILE · NPI 1366408213

Raul HerediaMD

PRACTICECAPITAL FAMILY PHYSICIANSSee all providers at this practice →
CardiologyFrankfort, KYI
CROSS-REFERENCE

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ProviderScore
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QUALITY · MIPS · 2024
Final MIPS score
94.3
Quality
87.3
Cost
0.0
Improvement activities
40.0
Promoting interop.
100.0
Payment adjustment
0.81%
APM Entity
INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024
Total received
$4K
Payment records
199
By payment type
Food and Beverage$4K
Education$32
PRESCRIBING · PART D · 2024
Total Rx claims
13,235
Beneficiaries
—
Total drug cost
$3.0M
Distinct drugs
73
Brand share
27.6%
Top prescribed drugs
Rosuvastatin Calcium1,188 claims
Metoprolol Succinate867 claims
Amlodipine Besylate861 claims
Atorvastatin Calcium809 claims
Apixaban729 claims
MEDICARE UTILIZATION · PART B · 2024
Total beneficiaries
1,304
Unique beneficiaries
—
Total services
2,152
Distinct HCPCS
14
Medicare payment
$116K
Peer benchmark
Q1
Q2
Q3
Q4
Q5
Total Medicare services vs. 240 Cardiology providers in KY — above median (cohort median 2,135).
REFERRAL NETWORK

Where Raul Heredia's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 48 inbound referrers · 98 outbound destinations.

Receives referrals from
Inbound — who sends patients here
PhysicianPatientsVisits
FRANKFORT HOSPITAL, INC.265748
Wesley Roney
Diagnostic Radiology · Valdosta, GA
143507
Anderson County Treasurer
Ambulance Service Provider · Lawrenceburg, KY
40113
David Dodd
Emergency Medicine · Charleston, SC
3783
James Gilbert
Family Practice · Lawrenceburg, KY
3384
Gregory Fuqua
Family Practice · Frankfort, KY
3388
Dolph Denny
Interventional Cardiology · Madisonville, KY
32124
Montubua Vasser-Smith
Internal Medicine · Mobile, AL
30131
Thomas Hamilton
Family Practice · Lawrenceburg, KY
30139
April Key
Nurse Practitioner · Georgetown, KY
30103
Allen Westerfield
Diagnostic Radiology · Lexington, KY
2741
Labone Of Ohio Inc
Clinical Laboratory · Cincinnati, OH
2675
Refers patients to
Outbound — where patients go next
PhysicianPatientsVisits
FRANKFORT HOSPITAL, INC.240741
David Sihau
Cardiology · Frankfort, KY
178979
Wesley Roney
Diagnostic Radiology · Valdosta, GA
127368
Sean Owens
Diagnostic Radiology · Washington, DC
122354
HOWARD, JOHN112332
Rahul Reddy
Internal Medicine · Louisville, KY
86756
Laboratory Corporation Of America Holdings
Clinical Laboratory · Dublin, OH
76177
City Of Frankfort
Ambulance Service Provider · Frankfort, KY
63160
UNIVERSITY OF KENTUCKY47108
Mostafa Amr
Nephrology · Lexington, KY
40182
BAPTIST HEALTHCARE SYSTEM, INC3993
SAINT JOSEPH HEALTH SYSTEM, INC39129
Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.