National Provider Identifier [NPI]: |
1417042953 |
Last Name Of The Provider |
LOUIS |
First Name Of The Provider |
DAVID |
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 |
350 30TH STREET |
Street Address 2 Of The Provider |
SUITE 540 |
City Of The Provider |
OAKLAND |
Zip Code Of The Provider |
946093487 |
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 |
79 |
Number Of Services |
4747 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
319221.5 |
Total Medicare Allowed Amount |
285456.44 |
Total Medicare Payment Amount |
204283.56 |
Total Medicare Standardized Payment Amount |
205412.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
582 |
Number Of Medicare Beneficiaries With Drug Services |
248 |
Total Drug Submitted ChargeAmount |
11186 |
Total Drug Medicare AllowedAmount |
6515.99 |
Total Drug Medicare PaymentAmount |
6202.38 |
Total Drug Medicare Standardized Payment Amount |
6202.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
4165 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
308035.5 |
Total Medical Medicare Allowed Amount |
278940.45 |
Total Medical Medicare Payment Amount |
198081.18 |
Total Medical Medicare Standardized Payment Amount |
199209.99 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
30 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
211 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
6 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9138 |