National Provider Identifier [NPI]: |
1164620522 |
Last Name Of The Provider |
ESPINOZA |
First Name Of The Provider |
ALEXANDER |
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 |
277 RANCHEROS DR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SAN MARCOS |
Zip Code Of The Provider |
920692976 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
249 |
Number Of Medicare Beneficiaries |
94 |
Total Submitted Charge Amount |
31332 |
Total Medicare Allowed Amount |
15658.03 |
Total Medicare Payment Amount |
10510.29 |
Total Medicare Standardized Payment Amount |
10223.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
1122 |
Total Drug Medicare AllowedAmount |
197.53 |
Total Drug Medicare PaymentAmount |
177 |
Total Drug Medicare Standardized Payment Amount |
177 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
201 |
Number Of Medicare Beneficiaries With Medical Services |
94 |
Total Medical Submitted Charge Amount |
30210 |
Total Medical Medicare Allowed Amount |
15460.5 |
Total Medical Medicare Payment Amount |
10333.29 |
Total Medical Medicare Standardized Payment Amount |
10046.37 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
76 |
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 |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8678 |