National Provider Identifier [NPI]: |
1033214010 |
Last Name Of The Provider |
FURST |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 W CARSON ST |
Street Address 2 Of The Provider |
BOX 8 |
City Of The Provider |
TORRANCE |
Zip Code Of The Provider |
905022004 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
307 |
Number Of Medicare Beneficiaries |
85 |
Total Submitted Charge Amount |
82215.68 |
Total Medicare Allowed Amount |
20943.31 |
Total Medicare Payment Amount |
14348.69 |
Total Medicare Standardized Payment Amount |
13400.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
307 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
82215.68 |
Total Medical Medicare Allowed Amount |
20943.31 |
Total Medical Medicare Payment Amount |
14348.69 |
Total Medical Medicare Standardized Payment Amount |
13400.01 |
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
30 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
11 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
75 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3577 |