National Provider Identifier [NPI]: |
1942360268 |
Last Name Of The Provider |
GREENBAUM |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15825 LAGUNA CANYON RD STE 103 |
Street Address 2 Of The Provider |
|
City Of The Provider |
IRVINE |
Zip Code Of The Provider |
926182126 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
661 |
Number Of Medicare Beneficiaries |
100 |
Total Submitted Charge Amount |
162278.35 |
Total Medicare Allowed Amount |
64069.85 |
Total Medicare Payment Amount |
47931.77 |
Total Medicare Standardized Payment Amount |
46665.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
146 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
20080 |
Total Drug Medicare AllowedAmount |
5235.03 |
Total Drug Medicare PaymentAmount |
4103.88 |
Total Drug Medicare Standardized Payment Amount |
4103.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
515 |
Number Of Medicare Beneficiaries With Medical Services |
100 |
Total Medical Submitted Charge Amount |
142198.35 |
Total Medical Medicare Allowed Amount |
58834.82 |
Total Medical Medicare Payment Amount |
43827.89 |
Total Medical Medicare Standardized Payment Amount |
42561.87 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
84 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
|
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8334 |