National Provider Identifier [NPI]: |
1316983737 |
Last Name Of The Provider |
GRANT |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1420 S CENTRAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GLENDALE |
Zip Code Of The Provider |
912042508 |
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 |
32 |
Number Of Services |
880 |
Number Of Medicare Beneficiaries |
574 |
Total Submitted Charge Amount |
593495 |
Total Medicare Allowed Amount |
131580.29 |
Total Medicare Payment Amount |
101192.6 |
Total Medicare Standardized Payment Amount |
94694.77 |
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 |
32 |
Number Of Medical Services |
880 |
Number Of Medicare Beneficiaries With Medical Services |
574 |
Total Medical Submitted Charge Amount |
593495 |
Total Medical Medicare Allowed Amount |
131580.29 |
Total Medical Medicare Payment Amount |
101192.6 |
Total Medical Medicare Standardized Payment Amount |
94694.77 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
329 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
292 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
79 |
Number Of Hispanic Beneficiaries |
145 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
428 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.5958 |