National Provider Identifier [NPI]: |
1841227006 |
Last Name Of The Provider |
MAHONEY |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 YGNACIO VALLEY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALNUT CREEK |
Zip Code Of The Provider |
945983122 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
197 |
Number Of Medicare Beneficiaries |
162 |
Total Submitted Charge Amount |
249924.3 |
Total Medicare Allowed Amount |
33182.89 |
Total Medicare Payment Amount |
25974.49 |
Total Medicare Standardized Payment Amount |
25127.7 |
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 |
46 |
Number Of Medical Services |
197 |
Number Of Medicare Beneficiaries With Medical Services |
162 |
Total Medical Submitted Charge Amount |
249924.3 |
Total Medical Medicare Allowed Amount |
33182.89 |
Total Medical Medicare Payment Amount |
25974.49 |
Total Medical Medicare Standardized Payment Amount |
25127.7 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
134 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2936 |