National Provider Identifier [NPI]: |
1417053075 |
Last Name Of The Provider |
MATHEW |
First Name Of The Provider |
ALLEN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2505 LUCAS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EUREKA |
Zip Code Of The Provider |
955013340 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
3611 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
1408262 |
Total Medicare Allowed Amount |
482596.35 |
Total Medicare Payment Amount |
377240.62 |
Total Medicare Standardized Payment Amount |
369181.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
282 |
Number Of Medicare Beneficiaries With Drug Services |
186 |
Total Drug Submitted ChargeAmount |
63327 |
Total Drug Medicare AllowedAmount |
26192.33 |
Total Drug Medicare PaymentAmount |
25647.89 |
Total Drug Medicare Standardized Payment Amount |
25647.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
3329 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
1344935 |
Total Medical Medicare Allowed Amount |
456404.02 |
Total Medical Medicare Payment Amount |
351592.73 |
Total Medical Medicare Standardized Payment Amount |
343533.69 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
332 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
34 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
3.6636 |