National Provider Identifier [NPI]: |
1780719823 |
Last Name Of The Provider |
WHALEY |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1555 SOQUEL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA CRUZ |
Zip Code Of The Provider |
950651705 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
678 |
Number Of Medicare Beneficiaries |
604 |
Total Submitted Charge Amount |
343717 |
Total Medicare Allowed Amount |
98816.85 |
Total Medicare Payment Amount |
76196.19 |
Total Medicare Standardized Payment Amount |
75428.79 |
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 |
30 |
Number Of Medical Services |
678 |
Number Of Medicare Beneficiaries With Medical Services |
604 |
Total Medical Submitted Charge Amount |
343717 |
Total Medical Medicare Allowed Amount |
98816.85 |
Total Medical Medicare Payment Amount |
76196.19 |
Total Medical Medicare Standardized Payment Amount |
75428.79 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
290 |
Number Of Non Hispanic White Beneficiaries |
513 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
394 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
210 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7642 |