National Provider Identifier [NPI]: |
1477516706 |
Last Name Of The Provider |
CHILINGIRIAN |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10243 GENETIC CENTER DR. |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921214427 |
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 |
19 |
Number Of Services |
164 |
Number Of Medicare Beneficiaries |
52 |
Total Submitted Charge Amount |
27601 |
Total Medicare Allowed Amount |
12561.48 |
Total Medicare Payment Amount |
8489.09 |
Total Medicare Standardized Payment Amount |
8272.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
1344 |
Total Drug Medicare AllowedAmount |
693.67 |
Total Drug Medicare PaymentAmount |
674.86 |
Total Drug Medicare Standardized Payment Amount |
674.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
139 |
Number Of Medicare Beneficiaries With Medical Services |
52 |
Total Medical Submitted Charge Amount |
26257 |
Total Medical Medicare Allowed Amount |
11867.81 |
Total Medical Medicare Payment Amount |
7814.23 |
Total Medical Medicare Standardized Payment Amount |
7597.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
35 |
Number Of Male Beneficiaries |
17 |
Number Of Non Hispanic White Beneficiaries |
29 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8385 |