National Provider Identifier [NPI]: |
1033379268 |
Last Name Of The Provider |
BLODGET |
First Name Of The Provider |
EMILY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD, MB, BCH, BAO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1520 SAN PABLO ST |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900335310 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
829 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
174100 |
Total Medicare Allowed Amount |
71729.02 |
Total Medicare Payment Amount |
55301 |
Total Medicare Standardized Payment Amount |
52240.06 |
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 |
10 |
Number Of Medical Services |
829 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
174100 |
Total Medical Medicare Allowed Amount |
71729.02 |
Total Medical Medicare Payment Amount |
55301 |
Total Medical Medicare Standardized Payment Amount |
52240.06 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
77 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
86 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
3.9955 |