National Provider Identifier [NPI]: |
1881768026 |
Last Name Of The Provider |
FRID |
First Name Of The Provider |
GERMAINE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 N PALM CANYON DR |
Street Address 2 Of The Provider |
111 |
City Of The Provider |
PALM SPRINGS |
Zip Code Of The Provider |
922624414 |
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 |
16 |
Number Of Services |
256 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
21915 |
Total Medicare Allowed Amount |
20331.01 |
Total Medicare Payment Amount |
14840.2 |
Total Medicare Standardized Payment Amount |
14581.84 |
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 |
16 |
Number Of Medical Services |
256 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
21915 |
Total Medical Medicare Allowed Amount |
20331.01 |
Total Medical Medicare Payment Amount |
14840.2 |
Total Medical Medicare Standardized Payment Amount |
14581.84 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
22 |
Number Of Non Hispanic White Beneficiaries |
90 |
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 |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2728 |