National Provider Identifier [NPI]: |
1164565339 |
Last Name Of The Provider |
SATEESH |
First Name Of The Provider |
BROOKE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
502 EUCLID AVE |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
NATIONAL CITY |
Zip Code Of The Provider |
919502931 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
3796 |
Number Of Medicare Beneficiaries |
643 |
Total Submitted Charge Amount |
396483 |
Total Medicare Allowed Amount |
247017.8 |
Total Medicare Payment Amount |
184768.33 |
Total Medicare Standardized Payment Amount |
176893.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
533 |
Number Of Medicare Beneficiaries With Drug Services |
141 |
Total Drug Submitted ChargeAmount |
7980 |
Total Drug Medicare AllowedAmount |
948.68 |
Total Drug Medicare PaymentAmount |
707.87 |
Total Drug Medicare Standardized Payment Amount |
707.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
62 |
Number Of Medical Services |
3263 |
Number Of Medicare Beneficiaries With Medical Services |
643 |
Total Medical Submitted Charge Amount |
388503 |
Total Medical Medicare Allowed Amount |
246069.12 |
Total Medical Medicare Payment Amount |
184060.46 |
Total Medical Medicare Standardized Payment Amount |
176185.72 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
193 |
Number Of Beneficiaries Age Greater 84 |
105 |
Number Of Female Beneficiaries |
352 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
185 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
116 |
Number Of Hispanic Beneficiaries |
256 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
426 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6192 |