National Provider Identifier [NPI]: |
1396761631 |
Last Name Of The Provider |
BROOME |
First Name Of The Provider |
DALE |
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 |
2 W FERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
REDLANDS |
Zip Code Of The Provider |
923735916 |
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 |
183 |
Number Of Services |
2350 |
Number Of Medicare Beneficiaries |
1464 |
Total Submitted Charge Amount |
120331.99 |
Total Medicare Allowed Amount |
107249.9 |
Total Medicare Payment Amount |
79745.31 |
Total Medicare Standardized Payment Amount |
77245.02 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
211 |
Number Of Beneficiaries Age 65 to 74 |
539 |
Number Of Beneficiaries Age 75 to 84 |
466 |
Number Of Beneficiaries Age Greater 84 |
248 |
Number Of Female Beneficiaries |
951 |
Number Of Male Beneficiaries |
513 |
Number Of Non Hispanic White Beneficiaries |
1115 |
Number Of Black or African American Beneficiaries |
77 |
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
208 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1087 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
377 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5041 |