National Provider Identifier [NPI]: |
1497727598 |
Last Name Of The Provider |
HERBERT |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
34800 BOB WILSON DR |
Street Address 2 Of The Provider |
NAVAL MEDICAL CENTER |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
92134 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1130 |
Number Of Medicare Beneficiaries |
863 |
Total Submitted Charge Amount |
1050761 |
Total Medicare Allowed Amount |
149346.52 |
Total Medicare Payment Amount |
113968.33 |
Total Medicare Standardized Payment Amount |
118262.2 |
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 |
40 |
Number Of Medical Services |
1130 |
Number Of Medicare Beneficiaries With Medical Services |
863 |
Total Medical Submitted Charge Amount |
1050761 |
Total Medical Medicare Allowed Amount |
149346.52 |
Total Medical Medicare Payment Amount |
113968.33 |
Total Medical Medicare Standardized Payment Amount |
118262.2 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
253 |
Number Of Beneficiaries Age 65 to 74 |
274 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
497 |
Number Of Male Beneficiaries |
366 |
Number Of Non Hispanic White Beneficiaries |
481 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
301 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
398 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.2624 |