National Provider Identifier [NPI]: |
1164538906 |
Last Name Of The Provider |
OULIGIAN |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 MEDICAL PLAZA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
956613037 |
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 |
20 |
Number Of Services |
869 |
Number Of Medicare Beneficiaries |
498 |
Total Submitted Charge Amount |
309547 |
Total Medicare Allowed Amount |
89276.55 |
Total Medicare Payment Amount |
67817.46 |
Total Medicare Standardized Payment Amount |
66973.08 |
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 |
20 |
Number Of Medical Services |
869 |
Number Of Medicare Beneficiaries With Medical Services |
498 |
Total Medical Submitted Charge Amount |
309547 |
Total Medical Medicare Allowed Amount |
89276.55 |
Total Medical Medicare Payment Amount |
67817.46 |
Total Medical Medicare Standardized Payment Amount |
66973.08 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
423 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.8159 |