National Provider Identifier [NPI]: |
1043418452 |
Last Name Of The Provider |
GLENN |
First Name Of The Provider |
JAMIESON |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
320 SANTA FE DR |
Street Address 2 Of The Provider |
SUITE 308 |
City Of The Provider |
ENCINITAS |
Zip Code Of The Provider |
920245138 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
909 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
464809 |
Total Medicare Allowed Amount |
205916.52 |
Total Medicare Payment Amount |
160091.23 |
Total Medicare Standardized Payment Amount |
151578.12 |
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 |
56 |
Number Of Medical Services |
909 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
464809 |
Total Medical Medicare Allowed Amount |
205916.52 |
Total Medical Medicare Payment Amount |
160091.23 |
Total Medical Medicare Standardized Payment Amount |
151578.12 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
302 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1815 |