National Provider Identifier [NPI]: |
1518013978 |
Last Name Of The Provider |
FLORES |
First Name Of The Provider |
ALONZO |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
229 S GLASSELL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORANGE |
Zip Code Of The Provider |
92866 |
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 |
22 |
Number Of Services |
499 |
Number Of Medicare Beneficiaries |
106 |
Total Submitted Charge Amount |
73230 |
Total Medicare Allowed Amount |
36295.29 |
Total Medicare Payment Amount |
26525.96 |
Total Medicare Standardized Payment Amount |
24392.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1445 |
Total Drug Medicare AllowedAmount |
703.86 |
Total Drug Medicare PaymentAmount |
683.51 |
Total Drug Medicare Standardized Payment Amount |
683.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
463 |
Number Of Medicare Beneficiaries With Medical Services |
106 |
Total Medical Submitted Charge Amount |
71785 |
Total Medical Medicare Allowed Amount |
35591.43 |
Total Medical Medicare Payment Amount |
25842.45 |
Total Medical Medicare Standardized Payment Amount |
23709.48 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
51 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
63 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
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 |
|
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0382 |