National Provider Identifier [NPI]: |
1710950589 |
Last Name Of The Provider |
BENSCH |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4628 GEORGETOWN PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
STOCKTON |
Zip Code Of The Provider |
952076204 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
19648 |
Number Of Medicare Beneficiaries |
386 |
Total Submitted Charge Amount |
742649.5 |
Total Medicare Allowed Amount |
291563.84 |
Total Medicare Payment Amount |
218120.63 |
Total Medicare Standardized Payment Amount |
213006.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
615.5 |
Total Drug Medicare AllowedAmount |
294.42 |
Total Drug Medicare PaymentAmount |
288.55 |
Total Drug Medicare Standardized Payment Amount |
288.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
19624 |
Number Of Medicare Beneficiaries With Medical Services |
386 |
Total Medical Submitted Charge Amount |
742034 |
Total Medical Medicare Allowed Amount |
291269.42 |
Total Medical Medicare Payment Amount |
217832.08 |
Total Medical Medicare Standardized Payment Amount |
212718.36 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
274 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
59 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
308 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
52 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9106 |