National Provider Identifier [NPI]: |
1710990833 |
Last Name Of The Provider |
QUINCY |
First Name Of The Provider |
DOMINIQUE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
795 EL CAMINO REAL |
Street Address 2 Of The Provider |
|
City Of The Provider |
PALO ALTO |
Zip Code Of The Provider |
943012302 |
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 |
32 |
Number Of Services |
450 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
92790 |
Total Medicare Allowed Amount |
43648.02 |
Total Medicare Payment Amount |
30883.23 |
Total Medicare Standardized Payment Amount |
26395.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
63 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
1713 |
Total Drug Medicare AllowedAmount |
1623.88 |
Total Drug Medicare PaymentAmount |
1584.93 |
Total Drug Medicare Standardized Payment Amount |
1584.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
387 |
Number Of Medicare Beneficiaries With Medical Services |
143 |
Total Medical Submitted Charge Amount |
91077 |
Total Medical Medicare Allowed Amount |
42024.14 |
Total Medical Medicare Payment Amount |
29298.3 |
Total Medical Medicare Standardized Payment Amount |
24810.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
12 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8219 |