National Provider Identifier [NPI]: |
1619158318 |
Last Name Of The Provider |
BEREDO |
First Name Of The Provider |
ANGELITA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
301 N PRAIRIE AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
INGLEWOOD |
Zip Code Of The Provider |
903014507 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
2595 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
238375 |
Total Medicare Allowed Amount |
142238 |
Total Medicare Payment Amount |
111786.81 |
Total Medicare Standardized Payment Amount |
105761.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
1395 |
Total Drug Medicare AllowedAmount |
373.24 |
Total Drug Medicare PaymentAmount |
365.8 |
Total Drug Medicare Standardized Payment Amount |
365.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
2564 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
236980 |
Total Medical Medicare Allowed Amount |
141864.76 |
Total Medical Medicare Payment Amount |
111421.01 |
Total Medical Medicare Standardized Payment Amount |
105395.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
200 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
74 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
209 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.551 |