National Provider Identifier [NPI]: |
1386645539 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
DWIGHT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6585 CLARK RD |
Street Address 2 Of The Provider |
SUITE 440 |
City Of The Provider |
PARADISE |
Zip Code Of The Provider |
959693500 |
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 |
60 |
Number Of Services |
2185 |
Number Of Medicare Beneficiaries |
559 |
Total Submitted Charge Amount |
309866.28 |
Total Medicare Allowed Amount |
172848.28 |
Total Medicare Payment Amount |
124442.46 |
Total Medicare Standardized Payment Amount |
121890.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
279 |
Total Drug Medicare AllowedAmount |
278.88 |
Total Drug Medicare PaymentAmount |
264.6 |
Total Drug Medicare Standardized Payment Amount |
264.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
2161 |
Number Of Medicare Beneficiaries With Medical Services |
559 |
Total Medical Submitted Charge Amount |
309587.28 |
Total Medical Medicare Allowed Amount |
172569.4 |
Total Medical Medicare Payment Amount |
124177.86 |
Total Medical Medicare Standardized Payment Amount |
121626.04 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
178 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
293 |
Number Of Male Beneficiaries |
266 |
Number Of Non Hispanic White Beneficiaries |
540 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
531 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1189 |