National Provider Identifier [NPI]: |
1780689406 |
Last Name Of The Provider |
FOGLAR |
First Name Of The Provider |
CHRISTIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6134 CAMINO VERDE DR |
Street Address 2 Of The Provider |
SUITE H |
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951191431 |
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 |
99 |
Number Of Services |
3169 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
1064194.99 |
Total Medicare Allowed Amount |
266955.71 |
Total Medicare Payment Amount |
204375.97 |
Total Medicare Standardized Payment Amount |
181910.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1496 |
Number Of Medicare Beneficiaries With Drug Services |
91 |
Total Drug Submitted ChargeAmount |
55640 |
Total Drug Medicare AllowedAmount |
24526.07 |
Total Drug Medicare PaymentAmount |
19166.24 |
Total Drug Medicare Standardized Payment Amount |
19166.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
96 |
Number Of Medical Services |
1673 |
Number Of Medicare Beneficiaries With Medical Services |
288 |
Total Medical Submitted Charge Amount |
1008554.99 |
Total Medical Medicare Allowed Amount |
242429.64 |
Total Medical Medicare Payment Amount |
185209.73 |
Total Medical Medicare Standardized Payment Amount |
162744 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
147 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
41 |
Number Of Hispanic Beneficiaries |
86 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4881 |