National Provider Identifier [NPI]: |
1932310877 |
Last Name Of The Provider |
BUSELLI |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 N SEPULVEDA BLVD STE 210 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANHATTAN BEACH |
Zip Code Of The Provider |
902666849 |
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 |
53 |
Number Of Services |
1463 |
Number Of Medicare Beneficiaries |
828 |
Total Submitted Charge Amount |
634947 |
Total Medicare Allowed Amount |
152539.46 |
Total Medicare Payment Amount |
117039.65 |
Total Medicare Standardized Payment Amount |
111808.56 |
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 |
53 |
Number Of Medical Services |
1463 |
Number Of Medicare Beneficiaries With Medical Services |
828 |
Total Medical Submitted Charge Amount |
634947 |
Total Medical Medicare Allowed Amount |
152539.46 |
Total Medical Medicare Payment Amount |
117039.65 |
Total Medical Medicare Standardized Payment Amount |
111808.56 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
163 |
Number Of Beneficiaries Age 65 to 74 |
230 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
211 |
Number Of Female Beneficiaries |
482 |
Number Of Male Beneficiaries |
346 |
Number Of Non Hispanic White Beneficiaries |
569 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
54 |
Number Of Hispanic Beneficiaries |
131 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
395 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
433 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2701 |