National Provider Identifier [NPI]: |
1174522056 |
Last Name Of The Provider |
NALLI |
First Name Of The Provider |
LYLE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2925 N. PALO VERDE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
90815 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
233 |
Number Of Medicare Beneficiaries |
64 |
Total Submitted Charge Amount |
34623.38 |
Total Medicare Allowed Amount |
22062.29 |
Total Medicare Payment Amount |
16300.16 |
Total Medicare Standardized Payment Amount |
14928.05 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
13 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
41 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
37 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
42 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.6154 |