National Provider Identifier [NPI]: |
1740242627 |
Last Name Of The Provider |
ALLAVIE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4605 BROCKTON AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
RIVERSIDE |
Zip Code Of The Provider |
925060107 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1529 |
Number Of Medicare Beneficiaries |
799 |
Total Submitted Charge Amount |
448540 |
Total Medicare Allowed Amount |
235818.83 |
Total Medicare Payment Amount |
166600.83 |
Total Medicare Standardized Payment Amount |
159853.82 |
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 |
28 |
Number Of Medical Services |
1529 |
Number Of Medicare Beneficiaries With Medical Services |
799 |
Total Medical Submitted Charge Amount |
448540 |
Total Medical Medicare Allowed Amount |
235818.83 |
Total Medical Medicare Payment Amount |
166600.83 |
Total Medical Medicare Standardized Payment Amount |
159853.82 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
302 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
471 |
Number Of Male Beneficiaries |
328 |
Number Of Non Hispanic White Beneficiaries |
595 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
27 |
Number Of Hispanic Beneficiaries |
105 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
656 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2656 |