National Provider Identifier [NPI]: |
1265415426 |
Last Name Of The Provider |
SUTTER |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2261 DOUGLAS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
956613831 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
11484 |
Number Of Medicare Beneficiaries |
2858 |
Total Submitted Charge Amount |
408897 |
Total Medicare Allowed Amount |
216765.53 |
Total Medicare Payment Amount |
167878.46 |
Total Medicare Standardized Payment Amount |
164231.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
19 |
Number Of Drug Services |
1532 |
Number Of Medicare Beneficiaries With Drug Services |
745 |
Total Drug Submitted ChargeAmount |
50558 |
Total Drug Medicare AllowedAmount |
29917.62 |
Total Drug Medicare PaymentAmount |
26663.59 |
Total Drug Medicare Standardized Payment Amount |
26663.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
9952 |
Number Of Medicare Beneficiaries With Medical Services |
2857 |
Total Medical Submitted Charge Amount |
358339 |
Total Medical Medicare Allowed Amount |
186847.91 |
Total Medical Medicare Payment Amount |
141214.87 |
Total Medical Medicare Standardized Payment Amount |
137568.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
385 |
Number Of Beneficiaries Age 65 to 74 |
1361 |
Number Of Beneficiaries Age 75 to 84 |
804 |
Number Of Beneficiaries Age Greater 84 |
308 |
Number Of Female Beneficiaries |
1654 |
Number Of Male Beneficiaries |
1204 |
Number Of Non Hispanic White Beneficiaries |
2419 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
122 |
Number Of Hispanic Beneficiaries |
163 |
Number Of American Indian Alaska Native Beneficiaries |
14 |
Number Of Beneficiaries With Race Not Else where Classified |
67 |
Number Of Beneficiaries With Medicare Only Entitlement |
2457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
401 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0422 |