National Provider Identifier [NPI]: |
1336180140 |
Last Name Of The Provider |
TUMAKAY |
First Name Of The Provider |
CESAR |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 COFFEE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MODESTO |
Zip Code Of The Provider |
953554201 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
174 |
Number Of Services |
14606 |
Number Of Medicare Beneficiaries |
2680 |
Total Submitted Charge Amount |
2944170.73 |
Total Medicare Allowed Amount |
480813.67 |
Total Medicare Payment Amount |
369809.02 |
Total Medicare Standardized Payment Amount |
353125.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
10902 |
Number Of Medicare Beneficiaries With Drug Services |
192 |
Total Drug Submitted ChargeAmount |
21347.88 |
Total Drug Medicare AllowedAmount |
5247.6 |
Total Drug Medicare PaymentAmount |
4113.98 |
Total Drug Medicare Standardized Payment Amount |
4113.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
170 |
Number Of Medical Services |
3704 |
Number Of Medicare Beneficiaries With Medical Services |
2679 |
Total Medical Submitted Charge Amount |
2922822.85 |
Total Medical Medicare Allowed Amount |
475566.07 |
Total Medical Medicare Payment Amount |
365695.04 |
Total Medical Medicare Standardized Payment Amount |
349011.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
594 |
Number Of Beneficiaries Age 65 to 74 |
1138 |
Number Of Beneficiaries Age 75 to 84 |
653 |
Number Of Beneficiaries Age Greater 84 |
295 |
Number Of Female Beneficiaries |
1727 |
Number Of Male Beneficiaries |
953 |
Number Of Non Hispanic White Beneficiaries |
1922 |
Number Of Black or African American Beneficiaries |
136 |
Number Of AsianPacific Islander Beneficiaries |
116 |
Number Of Hispanic Beneficiaries |
455 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
39 |
Number Of Beneficiaries With Medicare Only Entitlement |
1703 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
977 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4632 |