National Provider Identifier [NPI]: |
1144530205 |
Last Name Of The Provider |
GIVEN |
First Name Of The Provider |
DANIEL |
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 |
10666 N TORREY PINES RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371027 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Geriatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1275 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
301571 |
Total Medicare Allowed Amount |
162576.01 |
Total Medicare Payment Amount |
125588.22 |
Total Medicare Standardized Payment Amount |
122102.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
1275 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
301571 |
Total Medical Medicare Allowed Amount |
162576.01 |
Total Medical Medicare Payment Amount |
125588.22 |
Total Medical Medicare Standardized Payment Amount |
122102.92 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
151 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
231 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.915 |