National Provider Identifier [NPI]: |
1154432847 |
Last Name Of The Provider |
GONZALES |
First Name Of The Provider |
ARLENE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
722 E CHAPEL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA MARIA |
Zip Code Of The Provider |
934544524 |
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 |
36 |
Number Of Services |
2671 |
Number Of Medicare Beneficiaries |
574 |
Total Submitted Charge Amount |
235671 |
Total Medicare Allowed Amount |
189564.29 |
Total Medicare Payment Amount |
137343.14 |
Total Medicare Standardized Payment Amount |
143342.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
159 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
3300 |
Total Drug Medicare AllowedAmount |
2441.68 |
Total Drug Medicare PaymentAmount |
2373.57 |
Total Drug Medicare Standardized Payment Amount |
2373.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
2512 |
Number Of Medicare Beneficiaries With Medical Services |
574 |
Total Medical Submitted Charge Amount |
232371 |
Total Medical Medicare Allowed Amount |
187122.61 |
Total Medical Medicare Payment Amount |
134969.57 |
Total Medical Medicare Standardized Payment Amount |
140968.77 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
175 |
Number Of Female Beneficiaries |
376 |
Number Of Male Beneficiaries |
198 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
198 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
372 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
202 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.476 |