National Provider Identifier [NPI]: |
1790982254 |
Last Name Of The Provider |
TAGOYLO |
First Name Of The Provider |
GINO |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2301 BAHAMAS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933090663 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
122 |
Number Of Services |
2137 |
Number Of Medicare Beneficiaries |
1301 |
Total Submitted Charge Amount |
199992 |
Total Medicare Allowed Amount |
59639.97 |
Total Medicare Payment Amount |
46156.47 |
Total Medicare Standardized Payment Amount |
41378.79 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
203 |
Number Of Beneficiaries Age 65 to 74 |
428 |
Number Of Beneficiaries Age 75 to 84 |
358 |
Number Of Beneficiaries Age Greater 84 |
312 |
Number Of Female Beneficiaries |
735 |
Number Of Male Beneficiaries |
566 |
Number Of Non Hispanic White Beneficiaries |
755 |
Number Of Black or African American Beneficiaries |
119 |
Number Of AsianPacific Islander Beneficiaries |
313 |
Number Of Hispanic Beneficiaries |
69 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
679 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
622 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7219 |