National Provider Identifier [NPI]: |
1962431544 |
Last Name Of The Provider |
MATHEW |
First Name Of The Provider |
ALVIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18275 N 59TH AVE |
Street Address 2 Of The Provider |
SUITE 138 |
City Of The Provider |
GLENDALE |
Zip Code Of The Provider |
853081260 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
1281 |
Number Of Medicare Beneficiaries |
355 |
Total Submitted Charge Amount |
143254.08 |
Total Medicare Allowed Amount |
124616.04 |
Total Medicare Payment Amount |
92893.42 |
Total Medicare Standardized Payment Amount |
93674.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
63 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
1880.08 |
Total Drug Medicare AllowedAmount |
1710.6 |
Total Drug Medicare PaymentAmount |
1671.73 |
Total Drug Medicare Standardized Payment Amount |
1671.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
1218 |
Number Of Medicare Beneficiaries With Medical Services |
355 |
Total Medical Submitted Charge Amount |
141374 |
Total Medical Medicare Allowed Amount |
122905.44 |
Total Medical Medicare Payment Amount |
91221.69 |
Total Medical Medicare Standardized Payment Amount |
92002.63 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
323 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
335 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4264 |