National Provider Identifier [NPI]: |
1881684405 |
Last Name Of The Provider |
ALBERT |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
31001 RANCHO VIEJO RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SAN JUAN CAPISTRANO |
Zip Code Of The Provider |
92675 |
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 |
30 |
Number Of Services |
189 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
29026 |
Total Medicare Allowed Amount |
14399.68 |
Total Medicare Payment Amount |
9389.95 |
Total Medicare Standardized Payment Amount |
8381.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
1424 |
Total Drug Medicare AllowedAmount |
734.63 |
Total Drug Medicare PaymentAmount |
719.91 |
Total Drug Medicare Standardized Payment Amount |
719.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
171 |
Number Of Medicare Beneficiaries With Medical Services |
78 |
Total Medical Submitted Charge Amount |
27602 |
Total Medical Medicare Allowed Amount |
13665.05 |
Total Medical Medicare Payment Amount |
8670.04 |
Total Medical Medicare Standardized Payment Amount |
7661.19 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
31 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
58 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
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 |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
35 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
17 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7399 |